The diagnosis of early-stage ovarian cancer usually occurs by palpation of an asymptomatic adnexal mass during routine pelvic examination.2 In premenopausal women, the majority of these palpable pelvic masses are benign. Therefore, management of adnexal masses less than 8 cm in premenopausal women is generally to repeat the pelvic examination and imaging studies in 1 to 2 months. However, in postmeno-pausal women, a complex adnexal mass is more likely to be malignant, and surgical exploration is indicated.3 A fixed, solid, irregular pelvic mass is suggestive of ovarian cancer, especially in the presence of ascites.
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