Sonographic characteristics and histopathological findings of gynecologic masses at Moi Teaching and Referral Hospital

Abstract

Background: The burden of gynecologic pelvic masses is high globally with a prevalence as high as 56% in some regions. Sonography is an important initial diagnostic tool followed by histopathology for confirmation. These two diagnostic tools guide the clinical management of pelvic masses. Objective: To describe the sonographic characteristics and compare them with the histopathological findings of pelvic masses. Design: A cross sectional study. Setting: This study was conducted at the Radiology and Imaging department at the Moi Teaching and Referral Hospital, in Eldoret, from October 2013 up to October 2014. Subjects: Sixty-nine patients who were referred with a clinical indication of a pelvic mass, had a pelvic ultrasound scan, underwent surgery and specimen taken for histopathology. Results: A total of 69 patients with gynecologic masses were enrolled into the study. Mean age was 44.4 years (Standard Deviation=14.9) with 29% (n=20) aged between 25 and 34 years. A total of 52.9% (n=36) masses were characterized sonographically as solid and 47.1% (n=33) as cystic. Of these, 20.6% (n=14) were reported to have features of malignancy such as irregularity of contour, multiple vascularized septations, solid components or ascites. Uterine fibroids (42%, n=29) was the most common ultrasound diagnosis followed by ovarian cyst (20%, n=14) and dermoid cyst (7%, n=5). Histopathology reported 30.4% (n=21) as uterine fibroids, 23.2% (n=16) as benign ovarian cysts; 25% (n=17) were reported as malignant with leiomyosarcoma 10.1% (n=7) being the commonest malignancy. Conclusion: Most pelvic masses were benign uterine fibroids with unusually high proportion confirmed to be leiomyosarcoma.