Assessment of risk of malignancy index scoring and histopathological correlation in the diagnosis and management of adnexal mass

Abstract

: Pathologies of adnexal masses are commonly benign. The malignant lesions of adnexa carries a very low five-year survival rate, and hence the early recognition need to be done. There is no single gold standard investigation for the diagnosis of the malignancy of the adnexa. Risk of Malignancy Index (RMI) scoring system, combines the Serum CA 125(U/ML), Ultrasound score (U) and the menopausal status(M).: To assess the efficiency of Risk of Malignancy Index-3 (RMI-3) scoring system in discriminating benign and malignant adnexal mass, for early detection and management of malignant ovarian mass.: This is a prospective, observational study, among 50 female patients above the age of 25 years, diagnosed with adnexal mass under the Department of obstetrics and gynaecology, Government Rajaji Hospital, affiliated to Madurai Medical College, Madurai.All the study participants were subjected to detailed history taking, thorough clinical examination, ultrasonogram of abdomen and pelvis, and markers such as CA 125. Risk of Malignancy Index was calculated and correlated with the histopathological (HPE) findings of the excised tumours. : When the cut off of RMI score for predicting malignancy is 149.2 which had a sensitivity of 79.2%, specificity of 92.3%, positive predictive value of 90.47%, negative predictive value of 82.78% and a diagnostic accuracy of 86.01%.: Risk of Malignancy Index score is a simple tool, with a good diagnostic accuracy, hence it can be used as good screening tool for identification of the malignant lesions from the adnexal mass.