What is "Adnexal"?
Adnexal refers to the anatomical structures adjacent to the uterus, specifically the ovaries, fallopian tubes, and surrounding connective tissues. 1, 2
Anatomical Definition
- The term "adnexal" describes masses or pathology located in the ovaries, fallopian tubes, or surrounding tissues in the pelvis 1, 2, 3
- These structures are collectively called the "adnexa" because they are anatomically connected to or near the uterus 4
- Adnexal masses can originate from gynecologic structures (ovarian cysts, tubal ectopic pregnancies, hydrosalpinx) or nongynecologic sources (bowel abscesses, peritoneal inclusion cysts) 3, 5
Clinical Context
When clinicians refer to an "adnexal mass" or "adnexal pathology," they are describing abnormalities in this region that require evaluation:
- Most adnexal masses are benign, particularly in premenopausal women where functional ovarian cysts (follicular or corpus luteum cysts) are common 6, 7
- Adnexal masses occur in up to 20% of women throughout their lifetime 3
- The primary goal when evaluating adnexal findings is to exclude malignancy, though the vast majority prove benign 1, 2
Common Adnexal Pathologies
- Ovarian origin: Simple cysts, hemorrhagic cysts, endometriomas, dermoid cysts (teratomas), ovarian tumors 6, 8
- Tubal origin: Ectopic pregnancy, hydrosalpinx, tubo-ovarian abscess 6, 8
- Other structures: Pedunculated fibroids, peritoneal inclusion cysts, paraovarian cysts 6, 9
Imaging Terminology
- On ultrasound reports, "adnexal" indicates the mass is located in the region of the ovaries and tubes, though it may not always be possible to determine the exact structure of origin 6
- Transvaginal ultrasound is the essential first-line imaging modality for evaluating adnexal structures 6, 8, 7
- The "sliding sign" technique helps determine whether a mass is truly separate from the ovary or represents an ovarian lesion 8