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Solid adnexal lesions
Anatomy, embryology, pathophysiology
Please see Chapter 33 .
Imaging techniques and protocols
Please see Chapter 33 .
Specific disease processes
A purely solid adnexal lesion is usually considered benign, with a few exceptions. This chapter provides a differential for benign and malignant solid adnexal lesions with emphasis on their imaging appearances. However, it is worth noting that the most common ovarian tumors are epithelial ovarian tumors, which are predominantly cystic or part solid and cystic (see Chapter 33 ).
Benign solid adnexal masses
Ovarian fibroma
Fibromas and fibrothecomas are the most common solid ovarian tumor in asymptomatic women of all ages. They are considered an ovarian stromal tumor and are almost universally hormonally inactive.
Fibromas may be associated with ascites or pleural effusions, a constellation of findings known as Meig syndrome. They also have a strong association with basal cell nevus syndrome (Gorlin Goltz syndrome) and are seen in up to 75% of female patients.
Ultrasound
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Typically a solid hypoechoic mass, commonly unilateral.
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