Functional cysts are not true neoplasms but should be considered a variation of a normal physiologic process. This includes follicular, corpus luteum, and theca-lutein types, all of which ae benign and usually self-limited.

Ovarian neoplasms may have abdominal pain or complaints of increasing abdominal girth, nausea, and vomiting or they may be totally asymptomatic, with the mass being found on routine examination. The size of the tumor is not indicative of its malignant potential. Exquisite tenderness suggests torsion or hemorrhage of the cyst but may also occur with appendicitis and rupture. Ultrasound is helpful in the evaluation of an ovarian mass. Some ovarian neoplasms secrete protein tumor markers that can be assayed from peripheral blood samples. These markers are helpful in making a diagnosis of an ovarian tumor and in following clinical response and possible recurrences.

Surgical intervention should aim, whenever possible, at preservation of reproductive potential. Unless a malignancy is diagnosed on frozen section at the time of the procedure, conservative surgery should be undertaken with excision of the lesion and ovarian reconstruction. It is preferable to subject the patient to a second procedure after the final pathology specimens are reviewed rather than perform unnecessary ablative procedures.