About the Disease
Ovarian masses, whether cysts or tumors, are responsible for surgical procedures in 10% of women. The rates increased with the advent and expansion of ultrasonography. During the pre-menopausal period almost all masses are of benign origin.
The benign ovarian masses can be functional cysts, endometriomas, mature teratoma and tubovarian abscess (infection). Malignant ones come from different lineages.
For younger patients, the recommendation of the main international guidelines, such as that of the Royal College of Obstetrics and Gynecologists (RCOG) and American College of Obstetrics and Gynecologists is in pro of a conservative approach, mainly in the suspicion of simple or functional cysts.
Tumors suspected of malignancy are irregular solid tumors, presence of ascites (free fluid in the abdomen), presence of papillae / septa or of increased volume and high blood flow, identified in the imaging exam.
Ovarian tumor is a silent disease; 75% of diagnoses are made in advanced stages and there is still no safe nor non-surgical method for this purpose.
The approach to ovarian masses is not only based on ultrasound characteristics, but also on clinical examination, the patient’s history (symptoms and risk factors) and on complementary tumor markers. However, images with a high rate of malignancy suspicion should be referred to specialized oncology services for better investigation and treatment, offering patients a greater chance of survival.