Ovarian tumour: ovarian pregnancy. Diagnosis and management

An ovarian mass in a premenopausal patient has many differential diagnoses. In young patients the mass is most likely to be benign. Sometimes patients with an abdominal mass will present as acute abdomen. If the patients have an IUD and a positive test for serum HCG, an ectopic ovarian pregnancy has to be suspected. However one also has to take into consideration the possibility of an ovarian germ cell tumour. The latter occurs in young patients, presents as an ovarian mass and can produce HCG. The preoperative and even intraoperative diagnosis are difficult. In these cases where there is a suspected ovarian mass and no clear diagnosis a laparoscopic approach should be considered. Patients with an ovarian pregnancy have a good prognosis for future fertility and therefore conservative surgical management is advocated. The approach and treatment modalities of an ovarian pregnancy are discussed.