Ovarian Masses and Tumors
What Are Ovarian Masses and Tumors?
Ovaries can become enlarged (masses or tumors) due to cysts (ovarian and hemorrhagic ovarian cysts), masses (endometriomas), or neoplasms (growths). The vast majority of ovarian neoplasms in girls and young women are not cancerous.
What Causes Ovarian Masses and Tumors?
Ovarian cysts are usually associated with hormonal stimulation and/or ovulation. Ovarian masses like endometriomas are associated with endometriosis—an inflammatory condition when the glands and stroma of the uterine lining (endometrium) are found outside of the uterine cavity. The cause of both benign and malignant neoplasm is uncertain.
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What Are the Symptoms of Ovarian Masses or Tumors?
The type, size, and location of the mass or tumor will determine if the patient experiences symptoms. If present, more common symptoms include:
- Early satiety
- Urinary and bowel changes
- Menstrual irregularities
If the mass is large enough, particularly in younger patients, the mass may be felt or seen as a lower abdominal bulge.
How Are Ovarian Masses or Tumors Diagnosed?
Symptoms or physical findings may suggest an ovarian mass or tumor. Pelvic imaging, however, is required to confirm the diagnosis of an abnormal ovary. Pelvic ultrasound is used most frequently, however, if there’s uncertainty about the nature of the mass or tumor, a pelvic MRI may be needed as well. Depending on the size and nature of the mass or tumor, blood tests (ovarian tumor markers) may be ordered to help determine preoperatively the likelihood of a neoplasm being benign versus malignant. Preoperatively risk stratification (likelihood of malignancy) helps determine the best surgical procedure.
How Are Ovarian Masses and Tumors Treated?
Treatment of the ovarian mass or tumor depends on the most likely diagnosis and patient’s symptoms. Most ovarian cysts do not cause significant symptoms, resolve spontaneously, and therefore require no surgical intervention.
Endometriomas require surgical removal if they cause pain. Ovarian neoplasms will continue to grow and require surgical intervention. If preoperative risk stratification suggests a low likelihood of malignancy, ovarian sparing surgery (ovarian cystectomy) is performed to remove the mass or tumor only, leaving normal ovary intact. If there is a concern for an ovarian malignancy based on pelvic imaging and/or ovarian tumor markers, the entire ovary is removed.
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