Therapeutic goal or recommendations
The problem with diagnosing an ovarian tumor is that the vast majority can become malignant (malignant), and malignant ovarian tumors almost exclusively have a poor prognosis. Although the risk of malignancy increases with age (< 30 years about 3%, 40-50 years 5-15%, > 50 years up to 35%), it is basically present in any ovarian tumor and at any age. It is also independent of size, symptomatology or absence of symptoms, whether the tumor is cystic or solid, unilateral or bilateral. Since there is no drug therapy, surgical removal of the tumor is generally necessary for patient safety. The only exception is a suspected functional cyst, which can be waited for two to three to six months under close monitoring, as most of them regress spontaneously. The therapy of functional cysts with higher or high-dose ovulation inhibitors, which is still frequently performed and propagated today, is not useful according to the Cochrane analyses.
Unfortunately, to date, there is no reliable diagnostic differentiation between a benign and malignant ovarian tumor, although there have been many attempts to develop an algorithm from risk constellations and imaging techniques, especially by means of sonographic criteria (ultrasound criteria) (see also under “Further Therapy“).
