The incidental postmenopausal adnexal mass

Clin Obstet Gynecol. 2006 Sep;49(3):506-16. doi: 10.1097/00003081-200609000-00010.


The postmenopausal ovary continues to produce cysts; the prevalence in an ovarian cancer screening population approaches 18%. Yet 60% to 70% of unilocular cysts resolve spontaneously. Optimal management of an asymptomatic adnexal mass allows surveillance of women at low malignancy risk while triaging intermediate/high-risk women to surgery. Women with unilocular cysts on transvaginal ultrasound (TVS) and a normal CA-125 are monitored with repeat TVS at 3 to 6 months. Those with a complex mass <5 cm and normal CA-125 should have repeat TVS and CA-125 testing in 4 weeks. Surgery is recommended for any women with increasing morphologic complexity or a rising CA-125.

Publication types

  • Review

MeSH terms

  • CA-125 Antigen / blood
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Female
  • Humans
  • Incidence
  • Ovarian Cysts / diagnosis*
  • Ovarian Cysts / epidemiology
  • Ovarian Cysts / therapy*
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / therapy*
  • Postmenopause*


  • CA-125 Antigen