Sonography of ovarian masses:
9 key questions to guide clinical evaluation

Hallmark characteristics of benign and malignant lesions help point to the need for surgery. An expert sonologist details morphologic criteria that assist in diagnosis.

Dr. Hill is medical director, division of ultrasound, department of obstetrics, gynecology, and reproductive sciences, Magee-Womens Hospital, Pittsburgh, Pa; and professor, obstetrics and gynecology, University of Pittsburgh School of Medicine.

Although no sonologist can make a definitive diagnosis in every case of clinically suspected ovarian pathology, hallmark characteristics of an ovarian mass contribute greatly to the clinician’s appraisal of a tumor’s malignant potential.

Ultrasound reveals details about the size and architecture of ovarian masses that are indispensable in the initial evaluation of clinically suspect ovarian pathology. Nevertheless, determining whether a mass requires surgery remains a formidable challenge, thanks to the variability in the macroscopic characteristics of benign and malignant lesions. The task is further complicated by the diversity among ovarian tumors, which can be classified into 35 subtypes.¹