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May 25, 2026
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Maybe it was a routine pelvic ultrasound. Maybe you were getting checked for something else entirely. But there it is, a spooky medical description: adnexal mass. A phrase that sounds like it belongs in a surgical textbook, not your patient portal. What does it mean? Are you going to die? How do you even pronounce it?
Before you spiral into the darkest corners of the internet, here's some good news: It doesn't really mean anything. An adnexal mass describes where something was found, not what was found. It's a location marker, a clinical placeholder your doctor uses to say "we see something near the uterus and we need a closer look."
So you're at the starting point of an investigation. If this was Law & Order, the police would still be collecting evidence. You've got an entire episode ahead of you before the accused goes in front of a jury.
Not to make light of a scary situation. We get it: Reading those words alone, without a doctor on the other end of the phone, is its own kind of awful. This article will walk you through what the term actually means, the most common types (most of them are benign!), how doctors figure out what they're looking at, where the process shifts if you're pregnant, and what to ask at your next appointment so you walk in prepared.
(For the record, it's pronounced "ad-NECK-sul" — not a word you hear at many dinner parties.)
"Adnexal" is an anatomical word that means "attached to." So while technically speaking an adnexal mass could be attached to anything, for reasons only a Latin-speaking Renaissance doctor could justify, the adnexal region almost always refers to the area around the uterus: the ovaries, the fallopian tubes, and the surrounding ligaments and connective tissue.
So when imaging identifies an unexpected growth near the uterus, the report calls it an adnexal mass. This is a broad, intentionally nonspecific term used before a definitive diagnosis exists. It tells your medical team where to look. It says nothing about what the finding is.
But the outcome basically always falls into one of two basic structural categories. If it's filled with fluid, the adnexal mass usually gets called a cyst. And if it's solid, then your adnexal mass is called a tumor. But before that word sends your heart rate through the roof, "tumor" in medical language means "growth," not "cancer." A tumor has to meet many many more criteria before anybody starts dropping the big C word.
This structural distinction between cystic and solid is important, because it's one of the first things your doctor uses to assess next steps.
You might also see "left adnexal mass" or "right adnexal mass" on a report. The side indicates which ovary or fallopian tube is likely involved. But neither side is inherently more concerning than the other. If no side is indicated, that's not a cause for concern either: It might just be in the middle. Clinical significance comes from the mass's characteristics, not its zip code.
Adnexal masses will be diagnosed in roughly five to ten percent of women at some point during their lifetime, and the majority turn out to be benign. Most often, they're discovered incidentally (like during a routine pelvic exam, a fertility workup, or an early pregnancy ultrasound), rather than because of any specific symptoms.
It's always good to investigate unexpected anatomy, but more often than not, it will turn out to be a case of "look, and ye shall find." Bodies are weird.
Adnexal masses span a wide spectrum, from entirely normal cycle-related cysts to rare malignancies. But the benign ("harmless") end of that spectrum is far more crowded.
Functional ovarian cysts are common in people who menstruate. Specifically, follicular cysts and corpus luteum cysts are the most common. They arise directly from the ovaries as part of the menstrual cycle's normal mechanics, and frequently disappear on their own within a few weeks to a couple of months. They're so routine that many women have them without ever knowing.
Endometriomas are cysts filled with old blood from endometriosis tissue (sometimes called "chocolate cysts" for their dark appearance). They don't resolve spontaneously but are generally noncancerous. For women managing endometriosis or navigating fertility, they're a familiar and frustrating companion.
Dermoid cysts (mature cystic teratomas) are benign growths that can contain fat, hair, and occasionally even teeth. It's a combination that sounds alarming but isn't cancerous. They form from cells that got organized into the wrong place before you were born. Because they're made of your own tissue, your immune system leaves them alone. Unlike many other adnexal masses, dermoid cysts don't go away on their own. Whether they're monitored or removed typically depends on size and symptoms. One risk: Dermoids are one of the more common causes of ovarian torsion, where an ovary twists on itself. Torsion is a medical emergency, so dermoid cysts are always taken seriously, even when they're not causing obvious problems.
Non-ovarian masses also show up in the adnexal region. A "hydrosalpinx" (a fallopian tube blocked by fluid), a "tubo-ovarian abscess" (from pelvic infection), or a "pedunculated uterine fibroid" can all appear as a generic adnexal mass on imaging, which is part of why the term is intentionally vague.
Ectopic pregnancy is one critical exception. A fertilized egg implanting in a fallopian tube presents as an adnexal mass and is a medical emergency requiring immediate evaluation. This is the one scenario where urgency is non-negotiable.
The goal of evaluation isn't to panic. It's to characterize the mass and rule out the small number of cases that need intervention.
Transvaginal ultrasonography remains the standard for evaluation of adnexal masses. A small ultrasound probe is inserted vaginally to produce close-up images of the pelvic structures. It assesses the mass's size, shape, internal architecture, and blood flow patterns. What the ultrasound shows matters far more than the simple fact that a mass exists. About 90% of adnexal masses can be adequately characterized with ultrasound alone.
Specific features help organize risk profiles. Simple fluid-filled cysts with thin, smooth walls carry very low malignancy risk. That said, this risk of malignancy in simple cysts grows from about 0.8% in premenopausal women to 9.6% in postmenopausal women.
On the other end, imaging that shows solid components, irregular borders, thick internal walls ("septations") or increased blood flow are features that prompt closer investigation.
Blood markers add context but come with caveats. CA-125 is the most commonly ordered marker, but elevated CA-125 levels are associated with multiple conditions other than cancer, including pregnancy, pelvic inflammatory disease, menstruation, and obesity, making it prone to false positives. HE4 is sometimes used alongside CA-125 for additional context, though its role remains more limited.
Age and menopausal status are among the strongest risk predictors. Because malignancy is higher after menopause, the same imaging finding in a 32-year-old and a 62-year-old leads to very different clinical conversations.
For small, simple, asymptomatic masses, doctors often recommend watchful waiting. This isn't negligence; it's evidence-based practice. Basically, you will "see what happens and check back later." But if features suggest higher risk or symptoms are severe (suspected torsion, ruptured ectopic pregnancy), referral to a gynecologic oncologist or emergency evaluation will happen without delay.
Discovering an adnexal mass while pregnant takes an already complex experience and adds a layer of fear. So let's start with the reassuring part.
The diagnosis of adnexal masses in pregnancy has become more common as routine first-trimester ultrasound has become widespread, and most masses identified are simple cysts less than 5 cm. These can be safely observed and ultimately will resolve spontaneously. The incidence of first-trimester adnexal masses detected by ultrasound may be as high as 25%, with 85% resolving spontaneously. The vast majority are functional cysts like corpus luteal cysts that require no intervention.
Most identified adnexal masses in pregnancy resolve spontaneously, and expectant management in the first trimester should be encouraged as long as there is low suspicion for malignancy or complications such as torsion or rupture. Management decisions are shaped by trimester, mass size, imaging characteristics, and symptoms. Adnexal masses in pregnancy are mostly asymptomatic and sometimes aren't discovered until a C-section, during which the doctor may decide to remove it and spare you an additional surgery. These few extra moments do not add meaningful surgical risk.
One important distinction: an ectopic pregnancy is technically an adnexal mass. But it's not a viable pregnancy, and it requires immediate termination to protect the mother's life. Delays are dangerous, particularly in jurisdictions that restrict access to abortive procedures and drugs like mifepristone or misoprostol.
In extremely rare cases, "heterotopic pregnancy" is possible. This is essentially a case of twins, where one implants in the uterus and the other is ectopic. In these cases, assuming the uterine pregnancy is desired, surgery can remove the ectopic pregnancy while protecting the uterine fetus.
If you're wondering about regression: No, a uterine pregnancy won't suddenly become ectopic. You don't need to worry about a fetus crawling back up into your fallopian tubes. It would be like shoving a marble through the eye of a needle. It just doesn't happen.
Can an adnexal mass cause miscarriage? Most benign masses do not directly cause miscarriage. Concern does arise with ovarian torsion (when a large cyst causes the ovary to twist on its blood supply). Torsion is uncommon but requires urgent treatment, and can (but does not assuredly) affect pregnancy outcomes.
Knowing the terminology puts you in a better position to advocate for yourself. Here's how to use that knowledge when you're sitting across from your doctor.
Bring these questions:
Bringing organized records (prior imaging, lab results, menstrual history, medications) can dramatically improve the quality of this conversation. Every minute your doctor spends piecing together your history from scratch is a minute they're not spending on the question you came in with.
This is where having a structured way to track imaging results, blood work, and appointment notes makes a real difference. People navigating findings like this benefit from a single place that holds the threads. That's what myStoria was built for.
An adnexal mass is a starting point, not an endpoint. The term describes a finding near your uterus, ovaries, or fallopian tubes, and the overwhelming majority turn out to be benign. Your doctor's job is to characterize what they're seeing through imaging, context, and sometimes bloodwork. Your job is to show up informed, ask direct questions, and keep your records organized so the conversation moves forward instead of starting over.
The scariest part of this experience is usually the gap between reading a report and talking to your doctor. The single best thing you can do right now is to fill that gap with accurate information, and a plan for your next appointment.
An adnexal mass is a growth found near the uterus, typically involving the ovaries, fallopian tubes, or surrounding connective tissue. It's a descriptive term radiologists use to report a finding's location, not a specific diagnosis. Further evaluation is always needed to determine what the mass actually is.
An ovarian cyst is one type of adnexal mass, but not all adnexal masses are ovarian cysts. The adnexal region includes the fallopian tubes, ligaments, and surrounding tissue. Masses from those structures (hydrosalpinx, ectopic pregnancy, fibroids) all fall under the same umbrella term. The structural distinction between cystic (fluid-filled) and solid growth matters for evaluation.
Most benign adnexal masses do not directly cause miscarriage. The primary risk arises if a large cyst leads to ovarian torsion, which is uncommon but requires urgent surgical treatment. Ectopic pregnancy (a fertilized egg implanting outside the uterus) is a separate medical emergency that can be life-threatening if untreated, but it's a distinct condition from a mass found alongside a normal intrauterine pregnancy.
The designation "left" or "right" indicates which side of the pelvis the mass was found on, typically pointing to the corresponding ovary or fallopian tube. Neither side is inherently more dangerous than the other. What determines clinical significance is the mass's characteristics on imaging (size, structure, blood flow), not which side it's on.
The outcome depends entirely on the type. Many functional cysts resolve spontaneously within weeks, requiring no treatment at all. Others need monitoring and may eventually require surgical removal. The exceptions where delay is dangerous are ectopic pregnancy and ovarian torsion, both of which require immediate medical intervention.
