16 - Ovary

Abstract

Fine-needle aspiration (FNA) is a safe, minimally invasive, and relatively inexpensive procedure for the diagnosis of selected ovarian lesions. It is often used for small, incidental cystic masses that appear benign on sonographic or laparoscopic examination. Benign cytology, in combination with a benign ultrasound appearance, can reassure the physician and patient that an oophorectomy is not necessary. If imaging features suggest a malignancy, the clinician will often forego aspiration and recommend surgery. Because borderline and malignant ovarian tumors are treated by surgical resection, FNA is perceived as unnecessary in many such circumstances. Aspiration of suspicious ovarian masses is therefore uncommon, although it is recommended to confirm malignancy in patients with inoperable or metastatic disease. The reported sensitivity for a diagnosis of malignancy ranges widely from 25% to 93% but is probably closer to 50%. Criteria have been established for recognizing the benign conditions and malignant neoplasms of the ovary.