Aim: Besides primary ovarian tumor, a part of adnexal masses are metastatic colorectal cancers (CRC). Additionally, the risk of CRC is increased if the genitourinary cancers are present. In this study, we want to examine the separation of primer ovarian tumor and colorectal tumor metastasis and we investigated whether the routine colonoscopy is necessary in patients with adnexal mass. Material and Methods: This study included 58 women who underwent colonoscopy due to adnexal mass (Group 1) and 438 women who underwent colonoscopy for other reasons (Group 2). The colonoscopy results compared retrospectively in both groups between March 2014 and June 2016 at Harran University, Faculty of Medicine. Results: DThe mean age were 46.18 ± 16.89 (range 20-84) and 48.72± 17.95 (range 20-94) years in group 1 and 2, respectively. CRC was seen in two women (3.4%) and polyp in five (8.6%) in group 1. However, CRC was detected in 22 women (5%) and polyp in 71 (16.3) in group 2. The incidences of CRC and polyp were found to be lower in women with adnexal mass than group 2. Conclusions: The incidences of CRC and polyp were found to be lower in women with adnexal mass than those of without adnexal mass. Nevertheless, routine colonoscopy screening should be considered for women with adnexal mass due to the difficulties in the discrimination of primary and metastatic ovarian cancer in preoperative period.

Abstract

Aim: The aim of this study was to evaluate the role of dynamic and diffusion-weighted (DW) magnetic resonance imaging (MRI) in the differentiation of benign from malignant thrombus in patients diagnosed with portal vein thrombosis. Material and Methods: A total of 56 patients were analyzed, 27 with benign and 29 with malignant thrombus on abdomen dynamic and DW MRI. The b-value of DW MRI was 400 and 1,000 mm2/sec. ADC of portal vein thrombosis was measured. Characteristics of the DW MRI signal were recorded. Contrast imaging of the thrombus was performed. The diameter of the portal vein was measured. A comparison of the ADC values between the malignant and benign groups was made using the Mann-Whitney U test. Results: The mean ADC values of benign thrombus were calculated as 1.03±0.27 x 10-3 mm2/sec for b400, and 1.01±0.23 x 10-3 mm2/sec for b1000. The mean ADC values were calculated as 0.93±0.13 x 10-3 mm2/sec for b400 and 0.88±0.26 x 10-3 mm2/ sec for b1000 for malignant thrombus. No statistically significant difference was found between the groups (p=0.778). Malignant thrombus was reported to have higher signal intensity compared to the benign cases in DW MRI. Arterial mild contrasting was found with malignant thrombus with dynamic MRI on subtraction images. Statistically, a significant difference was found between the groups for portal vein diameter (p<0.05). Conclusion: Our results show that the DW MRI signal characteristics and dynamic MRI contrast media enhancement, with measurements of thrombosed portal vein diameters, are helpful in the differential diagnosis