News Article

I have a pelvic mass. What should I do next?


What is a pelvic mass?

A pelvic mass is a relatively common health issue and, in many cases, benign. These masses may form in the cervix, uterus, colon, intestine, bladder, or ovaries. Even if it is benign, they can cause problems depending on their size and placement relative to vital organs.

It’s estimated that 20% of women will develop a pelvic mass at some point in their lifetime.1 Women have a 5 to 10 percent lifetime risk of undergoing surgery for a suspected ovarian neoplasm

(National Institutes of Health Consensus Development Conference Statement. Ovarian cancer: screening, treatment, and follow-up. Gynecol Oncol. 1994;55(3 Pt 2):S4.).

What are the symptoms of a pelvic mass?

The most common symptoms of pelvic masses are pain, swelling, bloating, and frequent urination. However, in many instances, women are entirely asymptomatic or present with minor symptoms. Many times, asymptomatic pelvic masses are discovered by chance when imaging exams are done for other reasons. Occasionally asymptomatic masses are discovered on routine exam with your primary care or gynecologist.

What are the possible causes?

It is essential to understand the cause of the mass before deciding on treatment options, which should be discussed with your physician. There are many causes for pelvic masses some of which may be cause for concern depending on the size, location and visual characteristics. Though not an exhaustive list, the following are potential causes of a pelvic mass: ovarian cysts, endometriosis, fibroids, and ectopic pregnancy.

During an ultrasound, your physician will determine the mass’s characteristics. Elements such as size, consistency, and position are all critical components needed to help formulate the next steps.

If your doctor feels the mass appears suspicious for a malignancy, they may order a serum marker screening to check for elevated levels of cancer antigen 125 (CA125). This test has not been FDA cleared for this indication. Furthermore, recent studies suggest the use of CA125 to assess ovarian cancer risk prior surgery has limited ability to improve ovarian cancer outcomes. Furthermore, CA125 has low ability to detect ovarian cancer with a sensitivity to detect cancer at 60%. Studies also indicate that CA125 performs considerably worse on Black women.

What can I expect next?

Expect your physician to offer you several options depending on the severity of your condition.

Do not be afraid to be inquisitive. When we learn unsettling news, we sometimes forget to ask the questions most important to us. It is essential to completely understand your diagnosis, treatment plan, and discuss the best courses of action with your healthcare provider’s guidance. Make your voice heard when advocating for your healthcare.

References:

1. Moore RG, Bast RC, Jr. How do you distinguish a malignant pelvic mass from a benign pelvic mass? Imaging, biomarkers, or none of the above. J Clin Oncol. 2007;25:4159–4161.