A benign ovarian tumor is a non-cancerous growth of the ovary, such as a mature cystic teratoma (dermoid), a serous or mucinous cystadenoma, or a fibroma. Many are found by chance, while larger ones can cause pain, pressure or twisting of the ovary.
Key symptoms
- Often no symptoms
- Dull pelvic pain or pressure
- Bloating or feeling full quickly
- Sudden severe one-sided pain with vomiting (torsion)
What you find on exam
- Adnexal mass on bimanual pelvic exam
- Abdominal distension with large tumors
- Tenderness or peritoneal signs with torsion or rupture
- Vital signs
Tests
- Pregnancy test
- Transvaginal ultrasound: size, cyst contents, solid parts, blood flow
- CA-125 in selected cases, mainly after menopause
- Risk scoring (O-RADS) to judge the chance of cancer
Treatment basics
- Small simple cysts: follow-up with repeat ultrasound
- Laparoscopic cystectomy to remove the tumor and save the ovary
- Oophorectomy for large or suspicious masses, especially after menopause
- Emergency surgery for torsion to untwist and save the ovary
Red flags
- Sudden severe pelvic pain with vomiting (ovarian torsion)
- Solid parts, ascites or rapid growth on imaging
- Low blood pressure from rupture with bleeding
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.