In addition to uterine fibroids, ovarian cysts are also the most frequently asked questions by patients. Because ovaries are located deep in the pelvic cavity, most benign tumors do not have clinical symptoms even if they are relatively large, while most ovarian cancers are detected when clinical symptoms appear. This situation has also caused panic about ovarian tumors. With the popularity of checkups, the detection rate of ovarian cysts has increased. I would like to make a presentation on this, aiming to eliminate some unnecessary worries. First of all, many patients are found to have small ovarian cysts of 3 or 4 cm, do they need treatment? In this case, we must first rule out the possibility of ovarian physiological cysts, also called ovarian neoplastic lesions, with follicular cysts and corpus luteum cysts being the most common, usually not exceeding 5 cm in size, cystic in nature and with thin walls. They are usually no more than 5 cm in size, cystic and thin walled. Their formation is due to the cysts formed by the enlarged follicles and the corpus luteum after ovulation. So if your ultrasound was done before ovulation or during the second half of your menstrual cycle, the luteal phase, the cysts on your ovaries could be either of these. How can I identify them? You only need to repeat a vaginal ultrasound just after your period, when the follicles on the ovaries have not started to develop and there is no possibility of luteal cysts, so if they are either of these cysts, they will go away naturally. Some patients who find ovarian cysts are lulled into taking this and that herbal medicine, and then after their menstruation, they review the ultrasound and the cysts are gone, seemingly because of the medication, but in fact they will disappear even if you don’t take the medication. Through the above introduction, you should know that the best time to review ovarian tumor is within the first week of menstrual cycle. If a cyst is found on the ovary by ultrasound at this time, it suggests the possibility of ovarian tumor. Treatment needs to be decided according to the tumor size, suspicious diagnosis, tumor markers and other test results. The most common type of ovarian cysts is ovarian epithelial tumor, which is mostly manifested as cystic masses on ultrasound, persisting or gradually increasing in size, and surgery is recommended if the size exceeds 5 cm, but this criterion also needs to be individualized. Malignancy may be relatively increased, so even if small cysts appear, active treatment is recommended. In addition, if there are abnormal tumor markers, or if ultrasound indicates that the cyst is rich in blood flow signals or has papilla-like structures in the cyst wall, it indicates a non-benign tumor, and even if the cyst is not large, it should be actively operated. Depending on the patient’s age, ovarian cysts are removed in young patients, and the affected adnexa are removed in near-menopausal or post-menopausal patients, with the tumor removed as completely as possible and the specimen removed in a specimen bag to avoid contamination of the pelvic and abdominal cavity. The removed tumor is routinely examined by rapid pathology, and the next step of treatment is decided according to the rapid pathology results. If there is a high preoperative suspicion of ovarian malignancy and the ovarian tumor is large, open surgery may be considered. Another type of ovarian tumor that is more common is teratoma. Many patients believe that this tumor is born in their mother’s womb, but this is actually not the case. Teratomas are only tumors that originate from ovarian germ cells and are not present at birth. That is why a few teratomas recur after surgery. Most teratomas contain fatty tissue, which will appear as specific strong echogenic photophores under ultrasound, so most teratomas can be diagnosed by ultrasound. After the diagnosis of teratoma is basically confirmed, surgery is required, and the choice of surgery is the same as epithelial tumor. Most teratomas are benign, i.e. mature teratomas, while immature teratomas are malignant, accounting for 1%-3%. Mature teratomas can also become malignant, with an incidence of 2%-4%. The other common type of cyst that grows on the ovary but is not an ovarian tumor is ovarian chocolate cyst, which belongs to the category of endometriosis and is a cyst formed by ectopic endometrium on the ovary. Especially for young patients with fertility requirements, cochlea removal is feasible and postoperative ovulation promotion therapy is feasible to strive for early pregnancy. In patients without fertility requirements, the chance of recurrence is about 40% after surgery. The above introduced several most common ovarian tumor management methods, summarized above is to first rule out the possibility of physiological cysts, and after determining the diagnosis of ovarian tumor need to decide the treatment or surgery according to the tumor size, suspicious diagnosis, patient’s age and other factors, still emphasizing individualized treatment.