DETECTION/CONFIRMATION OF OVARIAN MASSES

An ovarian mass is recognized by its location in the adnexa, cul de sac or lower abdomen; and either a claw sign with the ovary or non identification of normal ovary (Fig 1). Non neoplastic masses such as a large physiologic cyst, tubo-ovarian abscess (Fig 2) ruptured ectopic pregnancy, or ovarian torsion (Fig 3) may sometimes closely mimic an ovarian mass. In such cases, the age of the patient, menstrual history, the effect of the menstrual cycle on the mass, clinical history, and presence of marked stranding in the peritoneal fat are useful in reaching the correct diagnosis. Although most of the ovarian neoplasms present as increasing abdominal girth, sometimes they present with lower abdominal pain due to torsion or rupture. In such cases, the correct diagnosis can be reached only by keeping a high degree of suspicion and laparoscopy or follow up imaging.