Ovarian tumours: general approach and balance between risk of unnecessary surgery and oncological risk.

Abstract: Ovarian masses are very frequent and represent one of the most common reasons for gynaecological consultation, even in the paediatric/adolescent population. In recent years, the increased availability of ultrasonography has revealed a great number of ovarian ‘neoplasms’ in different age groups. In more than 90% of cases, these are considered ‘functional’ and resolve spontaneously, and simple ultrasonographic follow-up can demonstrate their disappearance. Rarely, and mainly due to greater size, they can cause complications such as torsion, bleeding and rupture, and require surgical attention. Only a small portion of all ovarian masses are represented by tumours, which can be benign or malignant. The general approach to ovarian tumours must consist of a conservative attitude toward functional and benign neoplasms, and an aggressive and surgically/oncologically correct strategy for malignant tumours. The correct balance between these two positions has to rely on accurate diagnosis and an honest evaluation of the risk represented by a ‘wait and see’ policy. [Copyright &y& Elsevier]