Pathological features of persistent adnexal masses in pregnancy

BACKGROUND: The composition of pelvic masses during pregnancy is complex, and over >70% of masses are physiology. Determining the source and nature of tumor tissue is incredibly important in clinical practice, as the proportion of metastatic and low-grade tumors in adnexal masses increase during pregnancy. This study sought to analyze the pathological features of persistent adnexal masses in pregnancy. METHODS: A retrospective case analysis method was adopted to summarize the pathologic features of persistent adnexal masses in pregnancy in 228 patients at the Beijing Chao-Yang Hospital, Capital Medical University. RESULTS: Mature teratoma was the most common histopathological type of persistent adnexal masses in pregnancy (66/228, 28.95%), followed by the corpus luteum of pregnancy (38/228, 16.67%). Borderline/malignant tumors accounted for 5.70% (13/228) of tumors. Malignant adnexal tumor tissues were derived from multiple types of tissues. a single-factor analysis showed that borderline/malignant tumors had a significant relationship with the morphological features of mass in the ultrasound (P=0.000), and had a significant relationship with initial mass size (P=0.018). A multivariate binary logistic regression analysis indicated no certain independent risk factor. A significant difference in tumor pathology distribution was noted between those who underwent emergency surgery during pregnancy, elective surgery during pregnancy, and simultaneous tumor removal during cesarean section (χ(2)=24.22, P=0.000). CONCLUSIONS: A special particularity exists in the pathology distribution of persistent adnexal masses in pregnancy. Additionally, extensive histological sources and the need to rule out borderline/malignancy for solid cystic tumors were noted.