Ovarian masses: imaging and management is a key topic at this years ISUOG World Congress.

Accurate and timely characterization of ovarian lesions is crucial for determining an appropriate therapeutic course of action. The optimal assessment of adnexal masses often relies on current up to date imaging techniques and protocols, with ultrasound playing a critical role in the detection, characterization, and treatment of these masses.  

Transvaginal ultrasonography by a trained operator remains the gold standard for evaluating adnexal masses. It provides detailed imaging of the adnexa and ovaries and identifies the key characteristics that may indicate malignancy, thereby enabling early detection and timely intervention.  

Improving management of adnexal masses is essential for women to achieve the best possible outcomes. Preserving ovarian function and fertility, while alleviating anxiety regarding treatment ensures their overall health and well-being.  

 

Why is ovarian masses a key topic at ISUOG 2025?

Ovarian masses are a critical issue in women's health, and ultrasound plays a central role in their evaluation. This essential imaging modality provides unparalleled insight into the nature of ovarian masses and is essential for informed clinical decision making. Increasingly, ultrasound is being used in adolescents and during pregnancy, demonstrating its versatility in different patient populations. How can we improve diagnostic accuracy today? And what innovations are on the horizon? Join us at this year's congress to explore the latest advances-from state-of-the-art ultrasound to groundbreaking emerging technologies. Together, let's shape the future of ovarian mass diagnostics. And much more, including pelvic anatomy in ultrasound and the staging of gynecologic tumor! 

Francesa Moro Scientific Committee member

Recent UOG articles

 

Supplement your learning

Lectures

Ultrasound for the differential diagnosis of adnexal masses - comparison with surgical findings - Simone Ferrero

 

Ultrasound assessment of intra-abdominal spread of disease - Antonia Carla Testa

 

Ultrasound features of adnexal malignancies - Valentina Chiappa

 

Three-dimensional ultrasound for assessing women with gynecological cancer - Juan Luis Alcaza

 

VISUOG

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Malignant struma ovarii

Struma ovarii is a rare form of ovarian mature teratoma that contains mostly thyroid tissue. Malignant transformation is uncommon, only about 5% of struma ovarii being malignant. The variable sonographic features of struma ovarii and its rare occurrence makes the sonographic diagnosis very challenging.

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Ovarian dysgerminoma

Dysgerminomas are malignant ovarian germ-cell tumors. Malignant germ-cell tumors of the ovary occur in young women, 75% being diagnosed in the second and third decades of life. At macroscopic evaluation, ovarian dysgerminomas are characteristically solid and well-encapsulated with an average diameter of 15 cm.

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Sertoli-Leydig cell tumors

Sertoli cell tumors, Sertoli-Leydig cell tumors and Leydig cell tumors are sex cord-stromal tumors, and one of the rarest gynecological malignancies, accounting for 0.5-1 % of ovarian tumors. Sertoli cell tumors and Sertoli-Leydig cell tumors are most common in young patients.

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Brenner tumor

Brenner tumors are surface epithelial–stromal tumors of the ovary, which were first described in detail by Fritz Brenner in 1907. Brenner tumors represent 3.2 % of all ovarian tumors. About 99% of them are benign and most patients are postmenopausal. Brenner tumors are usually unilateral.

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Borderline ovarian tumor (BOT)

Borderline ovarian tumors (BOTs) are epithelial tumors with low grade of malignancy.  BOTs account for 10–15% of epithelial ovarian tumors. These tumors occur in younger women, with almost 30% of patients younger than 40 years, and are often diagnosed at an earlier stage than invasive carcinomas.

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Clear cells carcinoma

Clear cell carcinoma represents 5–25% of all ovarian carcinomas. Tumors can measure up to 30 cm in diameter. In most cases, the cut surface reveals a thick-walled cyst with papillary projections. The histologic patterns include tubulocystic, papillary and solid. The most representative image on ultrasound is a unilateral mass larger than 10 cm with a solid component.

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Endometrioid carcinoma

Endometrioid carcinoma represents 10-15% of ovarian epithelial carcinomas. In 15-20% of cases endometrial carcinoma is diagnosed at the same time. Tumors are solid or cystic with a mass protruding into the lumen. The most common microscopic pattern is characterised by a confluent glandular epithelial proliferation.

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Mucinous carcinoma

Mucinous carcinomas comprise 2–3% of ovarian carcinomas. Most mucinous carcinomas are well differentiated, containing areas of cystadenoma and atypical proliferative tumor mixed with areas of carcinoma. The size and laterality of the tumor can suggest whether it is primary or metastatic in nature.

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Serous carcinoma

Low grade serous carcinoma (LGSC) is a rare disease whereas high grade serous ovarian carcinoma (HGSC) is the most common ovarian malignancy. Non-invasive LGSCs are often bilateral and papillae on the outer surface of the cyst are frequently present. Invasive LGSCs exhibit a papillary growth.

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Metastases to the ovary

The ovary is a common site of metastases from malignant tumors. Most metastases in the ovaries originate in the gastrointestinal tract or the breast. The distinction between primary and metastatic ovarian neoplasm is of critical importance, since surgical cytoreduction is the treatment of choice for the former.

 

Patient information 

Ovarian Carcinosarcoma

This leaflet is to help you understand what an ovarian carcinosarcoma is, what tests you need and the implication of being diagnosed are for you, your baby and your family.

Metatasis of the Ovary

This leaflet is to help you understand what Metastases of the Ovary is, what tests you need and the implication of being diagnosed with Metastases of the Ovary for you, your baby and your family.

Metastatic Lesions

This leaflet is to help you understand what Metastatic Lesions are, what causes them, what tests you need and what the implications of being diagnosed with a tumor.

Malignant struma ovarii

This leaflet is to help you understand what Malignant struma ovarii is, how does it happen, what tests you need and what are the long term implications of the diagnosis.

Granulosa cell tumor

This leaflet is to help you understand what Granulosa cell tumor is, how does it happen, what tests you need and what are the long term implications of the diagnosis.

Epithelial ovarian carcinoma

This leaflet is to help you understand what Epithelial ovarian carcinoma is, what tests you need and the implication of being diagnosed with Epithelial ovarian carcinoma for you, your baby and your family.

Borderline Ovarian Tumor

This leaflet is to help you understand what Borderline Ovarian Tumor is, how does it happen, what tests you need and what are the long term implications of the diagnosis.

 

CME activities

Questions

Which descriptors are most useful to classify adnexal masses? 

What imaging tools are most useful for discerning malignancy in adnexal masses? 

What AI tools are available today to aid in the diagnosis of adnexal malignancy? 

Register for the ISUOG World Congress to get answers to these questions. 

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