What are the treatments for benign ovarian tumors?

The occurrence of benign ovarian tumors cannot be ignored by patients, because if it is not treated and the disease progresses, it may cause more impacts. During treatment, attention should be paid to the size of the tumor. If the diagnosis is confirmed, surgical treatment is recommended.

1. Regardless of the size of ovarian tumors, once diagnosed, surgical treatment is generally performed. For those who are young or wish to retain their fertility and whose tumors are not large, tumor removal (stripping) surgery can be performed. For larger tumors, ipsilateral oophorectomy can be performed. Ovarian tumor-like lesions such as follicular cysts, corpus luteum cysts, lutein cysts, chocolate cysts (i.e., ovarian endometriosis cysts), fallopian tube fimbriae effusions, and fallopian tube-ovarian cysts (inflammatory) must be ruled out before surgery.

2. Patients with benign ovarian tumors complicated by pedicle torsion, intracystic hemorrhage, infection, pelvic incarceration or cyst wall rupture should undergo surgery immediately once diagnosed.

3. During surgery for large ovarian cysts, the cyst should be removed as completely as possible. If adhesion occurs, it should be separated carefully to avoid tearing the cyst wall. If the cyst cannot be removed after extending the incision, puncture can be performed to release some of the fluid, but care must be taken to protect it from flowing into the abdominal cavity to prevent tumor cells from implanting in other tissues or causing chemical peritonitis.

4. After the ovarian tumor is removed, an autopsy should be performed immediately, and rapid (frozen) pathological sections should be sent for routine examination. If it is confirmed to be malignant, it should be treated as a malignant tumor.

5. For ovarian tumors in perimenopausal or postmenopausal women, even if they are benign, the entire hysterectomy and bilateral adnexa should be performed as appropriate.

6. For ovarian tumors that are suspected to be malignant or cannot be ruled out as malignant, preparation for total hysterectomy should be made before surgery.

7. The principles for the treatment of pregnancy complicated by ovarian tumors include: ovarian tumors discovered within 12 weeks of pregnancy that cannot be confirmed to be malignant and have no acute complications can be temporarily observed without rushing for surgery. Ovarian tumors discovered after 16 weeks of pregnancy may be treated surgically as appropriate. If an ovarian tumor is discovered after 28 weeks of pregnancy, the patient can wait until the pregnancy is full term. If the tumor blocks the birth canal after delivery, a cesarean section will be performed and the tumor will be removed at the same time. If it does not hinder the descent of the fetal head, surgery can be performed after delivery. Pregnancy with ovarian tumors and complications should be treated with surgery as soon as possible, regardless of the stage of pregnancy. Pregnancy complicated by ovarian tumors that have been confirmed to be malignant should be treated with surgery as soon as possible, regardless of the stage of pregnancy. The principles and scope of surgery are the same as those during the non-pregnancy period.