What Is an Ovarian Neoplasm?

Ovarian neoplasms happen when there is an abnormal mass of tissue forming on the ovary with cells growing and dividing more quickly than they should. Ovarian neoplasms are different than ovarian cysts, which form in response to hormonal stimulation, are very common, and usually go away on their own. 

Ovarian neoplasms typically require surgical removal. Thankfully, ovarian neoplasms are relatively rare in children, adolescents and young adult women, and the vast majority of them (80-90%) are not cancerous. Sometimes ovarian neoplasms cause pain, abdominal swelling or bloating, and/or bladder or bowel symptoms. Other times patients have no symptoms, and the mass is discovered by a doctor performing an abdominal exam, or by accident when imaging is done for something else.

What Kind of Testing Is Required if You Have an Ovarian Neoplasm?

Before we develop a treatment plan, we do our best to understand the likelihood of the ovarian neoplasm being cancerous. This risk assessment involves radiologic testing and a blood draw to measure ovarian tumor markers.  A pelvic ultrasound is the most common radiologic tool used, but patients may also undergo a CT scan or MRI test. 

Certain test findings raise concern for malignancy, like larger size, growths within the mass, enlarged lymph nodes, and growth into nearby organs, to name a few. We also draw blood to measure several ovarian tumor markers which are typically elevated in patients with a malignancy. Different types of cancer cause different patterns in the ovarian tumor marker levels and help us understand the type of malignant ovarian neoplasm involved.

What Type of Treatment Is Recommended for Ovarian Neoplasms?

Surgery is typically required to remove an ovarian neoplasm. The type of surgery we recommend is mostly determined by the likelihood or risk of the neoplasm being cancerous. In most patients the chance of malignancy is low, and we recommend a surgery which removes the ovarian mass and leaves the healthy ovary in place. This type of surgery is effective in treating benign ovarian neoplasms. Depending on the size of the mass, ovarian sparing surgery is done on the abdomen with either one large incision or several smaller ones.

If there is a concern that the mass is cancerous, we recommend the patient has surgical staging involving an incision on the abdomen, collecting abdominal fluid to test for cancer cells, examining the abdomen and pelvis for any enlarged lymph nodes or disease requiring biopsy or removal, and removal of the entire ovary and fallopian tube on that side. Removing the ovary and leaving the uterus and healthy ovary on the opposite side in place allows for normal periods and the potential for pregnancy moving forward.

What Is the Chance of a Recurrence and What Follow Up Is Needed after Surgery?

The good news is that most patients will not require additional surgery after their ovarian neoplasm is removed. Patients with a benign mass may experience another one in the future, but that is unlikely (<10%). They should monitor for any symptoms and have testing if symptoms develop.  Patients treated for a malignant ovarian mass require closer monitoring and may require additional medical treatment, including chemotherapy. Follow up for ovarian cancer will also require routine ovarian tumor markers testing and CT or MRI testing.

The Department of Pediatric and Adolescent Gynecology provides comprehensive patient care focused on the diagnosis, medical and surgical management of female reproductive health. To request an appointment, call (614) 722-2250 or visit our page.