Adnexal masses

A lump in the tissue of the adnexa which includes the uterus, ovaries, and fallopian tubesis known as an adnexal masses.
Adnexal masses are classified into gynaecological and non gynaecological. Gynecological adnexal masses : Gynecological adnexal masses can be further divided into ovarian, tubal, tubo-ovarian and paraovarian masses.

TUBAL MASSES

Tubal adnexal masses are those masses which affect the fallopian tube. Ovaries are connected to uterus through fallopian responsible for delivering the ovarian egg (ova) to the uterus during pregnancy. Ectopic pregnancy and hydrosalpinx are example of such masses:
Ectopic Pregnancies : Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms.
Hydrosalpinx :
A hydrosalpinx is a condition that occurs when a Fallopian tube is blocked and fills with serous or clear fluid near the ovary (distal to the uterus). The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape.

OVARIAN ADNEXAL MASSES

The ovaries are almond shaped & sized organs that produce eggs for the process of reproduction. They also produce estrogen & progesterone hormones. Ovarian adnexal masses can be benign or cancerous.

• Ovarian Cysts : An ovarian cyst is a closed sac like structure which contains fluid. Such a condition is common and can occur at any age. There are two types of ovarian cysts, the first types of cysts are functional and pathological cysts.
• Functional Cysts : They are usually harmless in nature and develop during the menstrual cycle. They resolve spontaneously in 2-3 menstrual cycles, requiring no medication and just observation.
• Follicular ovarian cysts : They are the most common type of cysts. The egg produced by ovaries moves into the uterus (womb). This egg grows in the follicle, which protects the egg with help of fluids. Normally when the egg is released, the follicle should burst but in some cases, the fluid contained by the follicle is not shredded even after releasing the egg, or in some cases the follicle does not release the egg itself. As a result such a follicle swells with fluid, and results in the formation of follicular ovarian cyst.
• Luteal ovarian cysts : Such cysts are not as common as follicular cysts. They are formed when corpus luteum is filled with blood. Corpus luteum is a tissue which is left behind after the egg is released.
• Pathological cysts/Benign Neoplasms
  
  1. Dermoid cysts (cystic teratomas) : Dermoid cysts are the most common type of pathological cysts for women under the age of 30. It forms due to a totipotential germ cell (a primary oocyte). A totipotential germ cell is a cell that can form all orders of cells that are required to form mature tissues. Dermoid cysts contain bone, skin, hair and sometimes even other tissues (e.g. teeth).
  2. Cyst adenomas : Cyst adenomas are more common to postmenopausal women. Such ovarian cysts develop from cells which cover the outer part of the ovaries. Since they are not inside the ovary they have potential to grow considerably large.
  3. Endormetrioma/chocolate Cysts : It is also known as endometriosis of ovaries and is caused when a tiny patch of endometrium grows inside the ovaries. During each menstrual cycle the endometrium grows, thickens and sheds. Normally, this blood leaves through the vaginal opening. But when this patch grows in the ovaries the blood has nowhere to go, which results in a buildup of blood and a brownish color.