Academic Journal of Cancer Research 7 (1): 08-18, 2014 ISSN 1995-8943 © IDOSI Publications, 2014 DOI: 10.5829/idosi.ajcr.2014.7.1.1107 Corresponding Author: Amal Y. Hassan, Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Egypt . 8 Two Dimensional Ultrasound and Doppler in Assessment of Adnexal Masses in Correlation to Histopathological Analysis Amal Y. Hassan, Ali A. Abd Ellatif and Fatma F. Darweesh Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Egypt Abstract: Adnexal masses are considered a group of the most common diseases in gynecology. Ovarian tumors, alone, represent two thirds of these cases. Even though histopathological examination of the adnexal lesion is the gold standard for the final diagnosis or exclusion of malignancy, clinical evaluation, 2D, Doppler studies in addition to tumor markers are reasonably accurate, helpful and non-invasive tools for assessment of adnexal lesions particularly distinguishing benign from malignant ovarian tumors. 2D ultrasound & Doppler are the main diagnostic tools in provisional diagnosis of these adnexal masses. This study included thirty patients with complex adnexal masses, the role of these tools was evaluated in the assessment of their lesions. It was found that, clinical picture alone has the lowest sensitivity to predict malignancy while applying these tools can improve the assessment of adnexal masses and provisionally differentiate between benign and malignant ovarian tumors. Key words: Adnexal masses Doppler ultrasound in correlation with Histopathological analysis Ovarian malignancy Two dimensional ultrasound INTRODUCTION masses to a trained gynecological oncologist for Adnexal masses are considered a group of the most known to improve survival [5]. Doppler US is useful in common diseases in gynecology, ovarian tumors, alone, cases with an apparent solid area or septum, while represent two thirds of these cases. Ovarian neoplasms transabdominal US is helpful for larger masses or those present an increasing challenge to the physician, and located superiorly or laterally in the pelvis, transvaginal ovarian cancer being the most lethal of all gynecological US provides optimal visualization of most adnexal cancers, presents late and responds poorly to treatment diseases. [1]. Malignant ovarian tumors are the fourth most common cause of death in women [2]. Approximately 4-24% of In General, US Features that Indicate Malignancy adnexal masses in premenopausal women and 39-63% in Include: postmenopausal women are malignant [3]. Because the patient usually complains of abdominal symptoms, she Solid component (particularly if there is visible flow may not have a pelvic examination, and a tumor may be in it at Doppler evaluation). missed. Benign conditions of the reproductive tract, as Thick septa. pelvic inflammatory disease, endometriosis and Ascites. pedunculated uterine leiomyoma, can simulate ovarian Doppler criteria that indicate malignancy as increased cancer. Non-gynecologic causes of an adnexal mass, vascularity. such as inflammatory disease or neoplastic colonic mass or even a pelvic kidney can simulate ovarian cancer US demonstration of a solid component within a [4]. A preoperative suggestion of malignancy can guide cystic mass is the most important predictor of malignancy, the gynecologist to refer women with suspected pelvic and conversely, malignancy is very unlikely in the appropriate therapy and optimized debulking, which is