An adnexal mass — a growth involving the ovary, fallopian tube, or surrounding tissue — is a common finding, and the great majority turn out to be benign. The key clinical challenge is distinguishing, as reliably as possible before surgery, which masses carry a higher risk of malignancy, so that the surgical approach and level of preparedness can be matched appropriately from the outset.

Evaluation begins with ultrasound and, where needed, MRI, alongside tumour markers and validated risk-scoring tools to estimate the likelihood of malignancy. This assessment shapes the surgical plan: masses with a low suspicion of cancer are typically managed with minimally invasive surgery aimed at preserving the ovary wherever possible, while those with higher suspicion are planned with full readiness to proceed to comprehensive cancer staging or debulking surgery in the same operation, guided by intraoperative frozen section analysis if needed.

Because getting this assessment right shapes the entire surgical plan, every case with meaningful risk of malignancy is discussed with gynaecologic oncology input, ensuring the surgical team and setting are appropriately prepared before the operation begins — avoiding the need for a second surgery if cancer is confirmed.