Suspecting the unsuspected in a large adnexal mass in a postmenopausal woman

Adnexal mass in postmenopausal woman is a diagnostic challenge. Due to the age, concern for malignancy is always there. At times however, despite the usual investigations, diagnosis remains elusive till histopathology report is at hand. To add to the enigma, ovarian masses in postmenopausal woman may remain silent till quite large and even among those which are symptomatic a predictable presentation may not be there. A careful clinical examination with a high degree of suspicion of clinical variants is thus recommended while dealing with ovarian tumors in postmenopausal women.