Treatment of Benign Ovarian Tumor in a Postmenopausal Patient with a Symptomatic Mass Characterized as Benign on Ultrasound

This protocol addresses the surgical management of a symptomatic ovarian mass that has been characterized as benign by ultrasound in a postmenopausal patient.

Clinical scenario

The patient is postmenopausal and presents with a symptomatic ovarian mass. Ultrasound characterization is benign. Because of the postmenopausal context and the presence of symptoms, surgical intervention is indicated, with the specific approach guided by the overall clinical picture and patient preferences.

Treatment approach

A surgical approach is indicated. The recommended intervention involves a specific type of bilateral procedure, though alternative surgical extents can also be considered depending on circumstances. The complete surgical algorithm, extent of resection options, and preferred operative approach are detailed in the full protocol →

Clinical goal

The primary goal of surgery is complete removal of the ovarian mass.

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References

DOI: 10.1016/j.jogc.2020.01.014

Postmenopausal women should undergo oophorectomy for a symptomatic cystic masse; bilateral salpingo-oophorectomy, or at least bilateral salpingectomy, could also be considered.

If the patient is symptomatic and postmenopausal, bilateral salpingo-oophorectomy is recommended but with the decision based on the overall clinical picture and patient wishes.

If surgery is performed for a symptomatic mass characterized as benign on ultrasound, unilateral or bilateral oophorectomy can be considered for postmenopausal women (strong, low) and ovarian cystectomy can be considered for premenopausal women if technically feasible (strong, low).

The goals of surgery for a symptomatic patient with a presumed benign ovarian mass should be to: (i) completely remove the mass, (ii) reduce the risk of recurrence, and (iii) preserve healthy ovarian tissue.

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