As the reproductive organ that dominates the rise and fall of the redhead throughout her life, the ovaries are the top priority of the uterus. What are the silent or shocking stories that can happen here? Luteal rupture, coarctation, cyst torsion, benign tumors …… 1, the status of the ovaries The ovaries are the female gonads, located deep in the pelvis, on both sides of the pelvic cavity, long known as the “accessories” of the uterus, but the sex hormones they produce (estrogen, progesterone and androgens) are typical of the antagonist, controlling every move of the uterus, the status is comparable to that of the “Empress Dowager”. “The ovaries are normally very large. Under normal circumstances, the ovaries are very small, almost double the size of a woman’s own thumb, a veritable “bullet point”! As the “Queen Mother’s residence”, the ovaries are revered for their role in a woman’s life and human reproduction, but they are also sometimes referred to as the “wrong place”. There are many health problems that can occur with the ovaries. Functional problems mainly cause menstrual irregularities and infertility, but here we will focus on structural problems, including ovarian enlargement, benign ovarian tumors and malignant tumors. 2. Common benign ovarian tumors ① Plasmacytic cystadenoma accounts for about 25% of benign ovarian tumors, mostly unilateral, varying in size, with a smooth surface and a sac filled with yellowish, clear plasma, hence the name. The former has only one cystic cavity (single room) with smooth walls; the latter often has multiple cystic cavities (multiple rooms) with multiple papillary protrusions. The prognosis of plasmacytoid cystadenoma is very good, but malignancy is also possible. The malignancy rate of simple type is 35%, while the malignancy rate of papillary type is as high as 50%. Mucinous cystadenoma accounts for 20% of benign ovarian tumors and is mostly unilateral, varying greatly in size from a few millimeters in the smaller ones to the entire abdominal cavity in the larger ones, making it the largest tumor in the body (once reported to weigh 170 kg). It is often multi-housed, with jelly-like intracapsular fluid and generally no papillae within the capsule. ③Mature cystic teratoma, also known as dermatomal cyst, is the most common benign ovarian tumor and can be said to occupy half of ovarian tumors. There are more than 40 types of ovarian malignant tumors, which can be simply categorized as epithelial tumors, germ cell tumors, interstitial tumors of the sex cords, supporting interstitial tumors, and unclassified tumors. The incidence of ovarian malignant tumors has increased 2 to 3 times in the past 40 years, and the mortality rate is the highest among gynecological malignant tumors. 3, pay attention to ovarian masses Although ovarian enlargement is not all tumors, the discovery of ovarian masses needs to be taken seriously enough, and doctors should be much more careful with ovarian masses than with uterine fibroids. Ovarian masses of non-neoplastic origin may shrink or disappear on their own during their development, whereas ovarian tumors usually do not disappear on their own, and their development and outcome depend on their nature. In benign cases, the growth is slow and sometimes the tumor grows very large without showing symptoms. In contrast, malignant ones grow rapidly and can quickly worsen the general condition of the patient. If a solid ovarian mass is found, regardless of its size, it should be considered pathological or tumorigenic. For ovarian cystic masses, if the diameter is less than 5 cm, it is possible that they are non-tumorigenic. They can be observed for 3 menstrual cycles (or 3 months) or treated with anti-infection therapy, and if they do not shrink or increase in size on review, they should be considered abnormal; for ovarian masses found in early pregnancy, if they do not shrink by 16 weeks of pregnancy, they should also be considered abnormal. When ovarian tumor grows up, it has a certain weight itself and will move its position in the pelvic cavity under the influence of position change (such as sudden standing up, after urination, sexual activity) and peristaltic movement of intestinal tube. Some tumors are shaped like fruits with tips, and the longer the tip, the more mobile the tumor is. The longer the tumor is, the more mobile the tumor is. When the tumor moves, it pulls the tissues or ligaments, causing discomfort or a feeling of falling in the lower abdomen. When the tumor continues to grow, the abdomen will also increase in size, but unfortunately, this phenomenon is often ignored by patients who think it is “fattening”. By the time a woman feels bloated or can feel the tumor herself, it is already quite large. The tumor can press on the bladder, causing frequent urination, or on the rectum, making it difficult to pass stool. If the tumor is allowed to grow without medical attention, it can fill the entire abdominal cavity like a pregnant woman and produce various symptoms of pressure, such as difficulty in breathing, indigestion, and edema of the lower limbs. With the improvement of people’s living standard, such large tumors are less common. 4.Auxiliary examination means Ultrasound examination is a routine auxiliary examination in the diagnosis of pelvic mass, with the advantage of no damage and can be performed repeatedly. Ultrasonography can measure the location and size of the tumor, and can also indicate the cystic or solid nature of the tumor. However, ultrasonography may miss the diagnosis of masses smaller than 2 cm. For women who are sexually active, transvaginal ultrasound is recommended for better accuracy and without suffering the pain of holding urine. If financial situation allows, one can also be more capricious and CT, MRI or even PET-CT is also possible, although the cost effectiveness is not better than ultrasonography. Laparoscopy can also be done for patients with high suspicion of ovarian malignancy to directly observe the pelvic and abdominal cavity and tumor, perform multi-point biopsy in suspicious areas, and aspirate peritoneal fluid for cytological examination. Tumor marker testing is also a means to detect ovarian cancer. Like other tumors in the body, ovarian tumors can make and release various products such as antigens, hormones and enzymes, which can be measured by special methods called tumor markers. Currently, the commonly used markers for ovarian tumors are: carcinoembryonic antigen 125 (CA125), carcinoembryonic antigen 199 (CA199), carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), chorionic gonadotropin beta subunit (beta-HCG), and so on. Ovarian tumors can undergo many complications, including torsion, rupture, and malignancy. Among them, ovarian cyst torsion is a common and urgent disease that needs to be managed. This is because if not treated promptly, there is a risk of losing the ovary.