Management of ovarian masses - Clinical situations & recommendations

Adenexal mass is a common clinical presentation. This clinical situation is a problem that affects women of all ages. The biggest challenge is that one should not miss out on a diagnosis of malignant ovarian tumor. An ovarian mass or cyst that raises the suspicion of malignancy is a common dilemma in a gynecological practice. In the United States, a woman has a 5-10% lifetime risk of undergoing surgery for a suspected ovarian neoplasm and an estimated 13-21% chance of this turning into a diagnosis of ovarian cancer.1 Most of the adnexal masses are benign but the first responsibility of the treating gynecologist is to exclude malignancy. Management decisions often are influenced by the age and family history and presentation of the patient. We purpose to review the most recent data on imaging modalities, operative assessment of the adnexal mass and preoperative models to predict the probability of ovarian malignancy. A woman's lifetime risk of developing ovarian cancer is approximately 1 in 70.2 The 5-year survival rate in women in whom stage I ovarian cancer has been diagnosed exceeds 90%; however, only 20% of cancers are detected at this stage.3