Скачать или смотреть 103. Benign Ovarian Mass (Part 1) | Adnexa, Benign Ovarian Cysts & Malignant Ovarian Tumors | USMLE

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Benign Ovarian Mass (Part 1) | Adnexa, Benign Ovarian Cysts & Malignant Ovarian Tumors | USMLE

In this high-yield OBGYN lecture, we explore the spectrum of ovarian masses, focusing on benign ovarian cysts, adnexal structures, and their differentiation from malignant ovarian tumors. Because adnexal pathology bridges benign gynecology and gynecologic oncology, understanding these masses is vital for clinical practice and is a commonly tested topic in USMLE Step 2 CK.

The adnexa refers to the structures adjacent to the uterus—namely the ovaries, fallopian tubes, and supporting ligaments. Ovarian masses may arise from normal physiological processes or from neoplastic growth. Benign ovarian cysts are commonly functional and include follicular cysts, corpus luteum cysts, and theca lutein cysts, often related to hormonal imbalances or ovulatory cycles. These cysts are typically small, unilateral, and resolve spontaneously.

Pathological benign masses include serous cystadenomas, mucinous cystadenomas, dermoid cysts (mature cystic teratomas), and endometriomas. Each has unique ultrasound characteristics—such as unilocular thin-walled appearance in serous cystadenoma or the “ground-glass” echogenicity seen in endometriomas. Recognition of these imaging features helps differentiate benign lesions from potential malignancies.

Malignant ovarian tumors, in contrast, tend to present as solid, irregular, or multilocular masses with papillary projections, septations, and ascites. Risk factors include age, nulliparity, family history, BRCA mutations, and hormonal factors. The CA-125 tumor marker is often elevated but is not specific for screening; it aids in post-diagnosis monitoring.

Clinically, benign ovarian masses may be asymptomatic or cause pelvic pain, pressure symptoms, menstrual irregularities, or torsion. Malignant tumors may present with abdominal distension, early satiety, or ascites. Transvaginal ultrasound is the imaging modality of choice, while CT or MRI helps assess complex or suspicious lesions. Surgical evaluation is essential when malignancy cannot be excluded.

By integrating gross anatomy, pathology, imaging characteristics, and clinical management, this lecture provides exam-ready conceptual understanding for USMLE Step 2 CK, equipping medical students, residents, and healthcare professionals to confidently distinguish between benign and malignant ovarian masses in Western gynecologic practice.

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