Clinical predictors in the evaluation of a pelvic mass

Objective: To determine the frequency by age of ovarian malignancies in women with a pelvic mass and to assess preoperative indicators for ovarian cancer. Methods: Inpatient charts from June 1, 1990, to August 30, 1992, were reviewed with preoperative diagnoses of a pelvic mass. Preoperative evaluation, surgical procedure, and pathologic diagnoses were recorded. Comparisons were made using the Fisher exact test. Results: In patients with ovarian disease, benign masses were found more commonly than malignancies (72 versus 13%, respectively). Ovarian malignancies were more common in patients over age 50 than in patients younger than 50 (25.6 versus 5.1%; p < 0.001). Preoperative platelet count, CA 125, and ultrasound findings did not identify patients with ovarian malignancy. Conclusions: Ovarian malignancies are uncommon in young women, but the risk of malignancy increases with age. Elevated CA 125 levels may prove to be helpful in evaluating pelvic masses in postmenopausal women.