Adnexale

Adnexale is a term that is most commonly encountered in medical literature to describe conditions involving the adnexal region of the female reproductive system. The adnexa refers to the structures adjacent to the uterus, notably the ovaries, fallopian tubes, and supporting ligaments. Adnexal disease encompasses a wide spectrum of disorders, including cysts, tumors, infections, and inflammatory processes.

Benign adnexal masses are the most frequent findings in routine pelvic examinations and imaging studies. Functional ovarian cysts, such as follicular, corpus luteum, and hemorrhagic cysts, typically regress spontaneously, whereas ovarian cystadenomas and dermoid cysts are subtypes of benign epithelial cysts that may require surgical removal if symptomatic or suspicious for malignancy. Malignant adnexal tumors, predominantly epithelial ovarian cancers, represent the leading cause of gynecologic cancer deaths worldwide. Diagnosis of adnexal lesions relies on transvaginal ultrasound, magnetic resonance imaging, and serum tumor markers such as CA-125, HE4, and, in some cases, CA 19-9.

Adnexal torsion is a surgical emergency characterized by torsion of the ovarian or tubal pedicle, leading to ischemia. Symptoms include sudden onset of lower abdominal pain, nausea, and vomiting. Prompt operative intervention restores perfusion and preserves ovarian reserve. Endometriosis frequently involves the adnexal region, presenting with dysmenorrhea, dyspareunia, and infertility. Management ranges from hormonal suppression to laparoscopy, depending on disease severity.

Screening strategies for ovarian cancer are limited to risk assessment models, such as the Gail model adaptations for ovarian pathology, and focused ultrasound in high‑risk populations. Early detection remains challenging; therefore, awareness of adnexal signs and timely imaging are critical for optimal outcomes.