Preoperative evaluation of ovarian tumors in the premenopause by transvaginosonography, ,

OBJECTIVE: The aim of the study was to establish reproducible sonomorphologic criteria by use of transvaginosonography in the preoperative evaluation of ovarian tumors in the premenopause. STUDY DESIGN: In a prospective study from 1987 to 1993 we investigated 1072 ovarian tumors. All tumors ≥3 cm were included in the study. To avoid unnecessary operations, all tumors we rescanned after 6 weeks. The sonomorphologic criteria were correlated with the histologic findings. RESULTS: A total of 4.3% of ovarian tumors in the premenopause were malignant. In the special group of sonographically simple ovarian cysts we found 0.8% malignancies. The incorporation of a control scan after 6 weeks in the management of ovarian cysts reduces the number of unnecessary operations on functional cysts. Only 5.5% of the functional tumors were operated on. The risk for malignancy in cystic-solid ovarian tumors is 17.0%, the highest of all sonomorphologic tumor types. CONCLUSIONS: The use of reproducible sonomorphologic criteria in combination with a control scan in premenopausal women with ovarian cysts proved to be efficient to reduce the number of unnecessary operations and to evaluate the risk for malignancy. (Am J Obstet Gynecol 1996;175:428-34.)