Question

What is the role of RMI in a postmenopausal woman presenting with an adnexal mass?

Hint:

RMI is particularly helpful in postmenopausal women, where the likelihood of malignancy is higher. It helps stratify risk and guide management decisions.

Answer 1

Step 1: Purpose of RMI.
The role of RMI in postmenopausal women presenting with an adnexal mass is to aid in risk stratification for malignancy. The RMI helps to differentiate benign from malignant ovarian masses, which is crucial for planning further management.
Step 2: Clinical Application.
In postmenopausal women, an adnexal mass raises concern for ovarian cancer. The RMI helps clinicians determine the urgency and type of further investigations, including whether to proceed with surgical intervention. A higher RMI indicates a greater likelihood of malignancy, guiding the decision for more aggressive management.
Step 3: RMI Calculation.
The RMI is calculated as:
\[ \text{RMI} = \text{CA-125} \times \text{ultrasound score} \times \text{menopausal status score}. \] If the RMI value is high, it suggests a need for surgery or further diagnostic procedures like CT or MRI scans.
Step 4: Prognosis and Follow-Up.
For low RMI values, conservative management and periodic follow-up may be appropriate. High RMI values require more urgent and aggressive treatment plans, including possible surgical removal and biopsy.