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Last reviewed: 16 Mar 2025
Last updated: 05 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors

Other diagnostic factors

  • pelvic pain
  • bloating and early satiety
  • palpable adnexal mass

Risk factors

  • pre-menopausal age group
  • early menarche
  • first trimester of pregnancy
  • personal history of infertility or polycystic ovary syndrome
  • increased intrinsic or extrinsic gonadotrophins
  • tamoxifen therapy
  • smoking
  • personal or family history of endometriosis

Diagnostic investigations

1st investigations to order

  • transvaginal ultrasonography

Investigations to consider

  • serum cancer antigen (CA)-125
  • colour power Doppler ultrasonography of abdomen/pelvis
  • MRI of abdomen/pelvis
  • CT imaging of abdomen/pelvis
  • karyotype analysis
  • laparoscopy/laparotomy and histopathology

Emerging tests

  • PET imaging of abdomen/pelvis
  • serum biomarkers (ovarian adnexal mass assessment score test system)

Treatment algorithm

Contributors

Authors

Sareena Singh, MD

Assistant Professor

Department of Obstetrics and Gynecology

Northeast Ohio Medical University

Rootstown

OH

Director of Gynecologic Oncology

Aultman Health Foundation

Canton

OH

Disclosures

SS declares that she has no competing interests.

Acknowledgements

Dr Sareena Singh would like to gratefully acknowledge Dr Michael P. Hopkins, Dr Christina N. Kufel, Dr Lauren M. Blue, Dr Jay R. Patibandla, and Dr Laura K. Randolph, previous contributors to this topic.

Disclosures

MPH, CNK, LMB, JRP, and LKR declare that they have no competing interests.

Peer reviewers

John Bachman, MD

Consultant in Family Medicine

Parker D Sanders and Isabella Sanders Professor of Primary Care

Rochester

MN

Disclosures

JB declares that he has no competing interests.

David Chelmow, MD

Chair

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Disclosures

DC declares that he has no competing interests.

T. Justin Clark, MD (Hons), MRCOG

Consultant Obstetrician and Gynaecologist

Birmingham Women's Hospital

Obstetrics and Gynaecology

Birmingham

UK

Disclosures

TJC declares that he has no competing interests.

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