What is "Adnexal"?
"Adnexal" refers to structures adjacent to the uterus, specifically the ovaries, fallopian tubes, and surrounding connective tissues in the pelvis 1, 2.
Anatomical Definition
The term "adnexal" describes the region containing:
- Ovaries (primary reproductive organs)
- Fallopian tubes (oviducts connecting ovaries to uterus)
- Surrounding supporting structures (broad ligament, peritoneal tissues, blood vessels)
When clinicians refer to an "adnexal mass," they mean a growth or abnormality originating from any of these structures 1.
Clinical Context
Common Adnexal Pathology
Benign masses (most common) include 1:
- Functional cysts (follicular, corpus luteum)
- Dermoid cysts/teratomas
- Endometriomas
- Cystadenomas (serous, mucinous)
- Hydrosalpinx (fluid-filled fallopian tube)
- Pedunculated fibroids
- Peritoneal inclusion cysts
Malignant masses (approximately 2% in pregnancy, higher in postmenopausal women) include 1, 3:
- Epithelial ovarian cancers
- Germ cell tumors
- Sex cord-stromal tumors
Why the Term Matters
The distinction between "adnexal" versus "ovarian" is clinically important because:
Not all adnexal masses originate from the ovary - pedunculated fibroids, hydrosalpinx, and paratubal cysts are adnexal but not ovarian 1
Imaging interpretation requires identifying the ovary separately - seeing normal ovarian tissue distinct from a mass helps narrow the differential diagnosis 1
Surgical planning differs - the origin of the mass determines the surgical approach and specialist involvement 1
Imaging Evaluation
Transvaginal ultrasound is the primary modality for evaluating adnexal structures, allowing characterization of masses as cystic, solid, or mixed 1, 4. Adnexal masses can be definitively diagnosed as benign, malignant, or indeterminate based on specific ultrasound or MRI features 1.
Important Clinical Caveat
In the context of skin pathology, "adnexal" has a completely different meaning - it refers to skin appendages (hair follicles, sweat glands, sebaceous glands) 5. This dermatologic usage is unrelated to gynecologic anatomy and should not be confused with pelvic adnexal structures.