Imaging Has Revealed an Ovarian Mass in Your Asymptomatic Patient — Now What?

An ovarian mass will be detected in as many as 20% of women at some point in their lives. As ultrasound imaging becomes more commonly used, many such masses are identified in asymptomatic women, raising uncertainty about appropriate next steps. In a review, gynecologic oncologists detail the roles of ultrasound morphology and serum biomarkers to evaluate ovarian masses.

Ultrasound-determined morphology can classify ovarian masses as likely benign, likely malignant, or indeterminate. Unilocular (simple) cysts are common and essentially all benign. Risk for invasive malignancy is also extremely low for cystic ovarian masses with septations <2 mm thick but without solid areas or papillary projections (mural nodules). These two types of cystic o…