P08.09: Pelvic masses score (PMS): a new scoring system to evaluate pelvic masses

Methods: A retrospective chart review of all cases referred for FNA between March 2003 to Feb 2005 was conducted. A total of 41 referrals were made. Volume of the fluid removed, cytology results and follow-up to 1 year was obtained. Result: Out of the 41 referrals, 9 cases were cancelled at the time of the procedure due to solid mass (in 3 cases) and small cyst size of 4 cm or less (6 cases). A total of 32 aspirations were performed in 23 patients. The maximal cyst diameter at aspiration ranged between 4–19 cm. One failed procedure was reported. In 21 patients the cytology result was negative for malignant cells. Cytology reported as non-conclusive in one patient who was lost to follow-up. One patient who underwent FNA due to her high surgical risk (age 91), the cytology was suggestive of malignancy. Repeated cytology was negative however. Cyst recurrences were recorded in 7 patients. FNA was repeated in all, with a negative cytology result. The main time to recurrence was 6–12 months. Conclusion: Based upon our small sample size review we conclude that FNA of large adnexal cysts with a simple benign appearance on U/S is a reasonable alternative to surgery in premenopausal women. CA 125/C19 may be a useful adjuvant in evaluating adnexal masses prior to FNA in postmenopausal women. Based on a 30% recurrence rate within one year of the procedure, follow-up U/S is recommended twice yearly.