Recognizing features and findings of benign adnexal masses on multiple imaging modalities, enabling their diagnosis when possible or narrowing their differential, and allowing for a more focused clinical approach.

Benign adnexal masses are a common finding (incidental or otherwise) in pre and post-menopausal women, and present an important diagnostic challenge that, while not always possible through imaging findings alone, can most of the time provide invaluable clues as to the benign/malignant probability and help guide the patient’s management.

A pictorial review aiming to address theoretical concepts and illustrate some of the imaging findings and differential diagnosis of the most common types of benign adnexal masses based on ultrasound, CT and MRI scans performed at our institution, and discussing features pointing towards benign or malignant etiology such as solid components, vascularity, accompanying ascites and others. General approach principles The first line, go-to examination for pelvic mass diagnosis and characterization is transvaginal ultrasound. Advancements in the field and hardware have allowed this radiation free, low...

Even when a specific diagnosis is not possible based exclusively on imaging findings there are still important clues that may contribute to narrowing the differential and influence patient management. Transvaginal ultrasound excels at lesion characterization and should allow adequate study of most adnexal masses. Undetermined lesions should undergo aditional cross-sectional imaging, such as MRI when available and/or not contra-indicated, or otherwise MDCT for further study and characterization.

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