The value of the risk of malignancy index in the preoperative evaluation of patients with adnexal masses

The uterine adnexa (gynecologic origin) consist of the ovaries, the Fallopian tubes, and the uterine ligaments. Although adnexal pathology often involves one of these structures, contiguous structures of non-gynecologic origin also may be involved.Adnexal masses are common among women of all ages and two thirds of ovarian tumors are encountered during reproductive years, of those the risk of malignancy in an ovarian mass in patients above 40 years is remarkably high although the premenarchal lesions are usually malignant.Ovarian cancer, a disease of no settled screening or prevention approaches until now, is still a silent killer of many women because of its late presentation. So it does not need an extra delay in management which could be caused by misleading preoperative data or suboptimal surgical intervention.Even though histopathological examination of the adnexal lesion is the gold standard for the final diagnosis or exclusion of malignancy, clinical evaluation, ultrasound 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.Tumor marker, CA125 is the most common tumor marker used in evaluating ovarian masses but it cannot be used as a screening tool, as it increases in many other diseases, However it is useful to detect prognosis and follow up after treatment.