Benign ovarian tumours

1. Big picture

Benign ovarian tumours are common adnexal masses arising from ovarian tissue. Most ovarian masses in reproductive-age women are benign functional cysts, but every adnexal mass must be assessed for three immediate questions:

1. Is she pregnant?
2. Is it an emergency: torsion, rupture, haemorrhage?
3. Could it be malignant?

The exam pattern is:

Adnexal mass on examination/ultrasound
→ pregnancy test
→ transvaginal ultrasound morphology
→ tumour markers according to age/risk
→ observe simple functional cysts
→ operate if symptomatic, persistent, large, torsion, rupture, or suspicious

The safest clinical rule: **do not treat an ovarian mass as “