Lesions of the ovary

1. Big picture

“Ovarian lesion” is an umbrella term. In the exam, do not jump straight to “ovarian cancer.” First classify the lesion clinically:

Ovarian lesion
↓
Functional cyst?
Benign neoplasm?
Endometrioma?
Inflammatory/tubo-ovarian mass?
Torsion/rupture emergency?
Hormone-producing tumour?
Malignancy?

The examiner wants you to show a safe clinical workflow:

Pelvic pain / mass / bloating / menstrual disturbance / infertility
↓
Check age + pregnancy status + haemodynamic stability
↓
Pelvic examination + transvaginal/transabdominal ultrasound
↓
Assess benign vs suspicious ultrasound features
↓
Use tumour markers according to age and suspected tumour type
↓
Observe, operate, refer to oncology, or treat emergency

The most important first question in reproductive-age women:

“Could this be pregnancy-related, especially ectopic pregnancy?”

---