Value of ultrasound and magnetic resonance imaging combined with tumor markers in the diagnosis of ovarian tumors

BACKGROUND Compare the diagnostic performance of ultrasound(US),magnetic resonance imaging(MRI),and serum tumor markers alone or in combination for detecting ovarian tumors.AIM To investigate the diagnostic value of US,MRI combined with tumor markers in ovarian tumors.METHODS The data of 110 patients with ovarian tumors,confirmed by surgery and pathology,were collected in our hospital from February 2018 to May 2023.The dataset included 60 cases of benign tumors and 50 cases of malignant tumors.Prior to surgery,all patients underwent preoperative US and MRI examinations,as well as serum tumor marker tests[carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)].The aim of the study was to compare the diagnostic performance of these three methods individually and in combination for ovarian tumors.RESULTS This study found statistically significant differences in the ultrasonic imaging characteristics between benign and malignant tumors.These differences include echo characteristics,presence or absence of a capsule,blood flow resistance index,clear tumor shape,and blood flow signal display rate(P<0.05).The apparent diffusion coefficient values of the solid and cystic parts in benign tumors were found to be higher compared to malignant tumors(P<0.05).Additionally,the time-intensity curve image features of benign and malignant tumors showed significant statistical differences(P<0.05).The levels of serum CA125 and HE4 in benign tumors were lower than those in malignant tumors(P<0.05).The combined use of US,MRI,and tumor markers in the diagnosis of ovarian tumors demonstrates higher accuracy,sensitivity,and specificity compared to using each method individually(P<0.05).CONCLUSION US,MRI,and tumor markers each have their own advantages and disadvantages when it comes to diagnosing ovarian tumors.However,by combining these three methods,we can significantly enhance the accuracy of ovarian tumor diagnosis,enabling early detection and identification of the tumor’s nature,and providing valuable guidance for clinical treatment.

Is There Re-staging Surgery Necessity for Borderline Ovarian Tumors

Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurrence and survival.Methods:We retrospectively reviewed the medical records of patients with BOTs.A total of 901 patients were eligible for inclusion in the study,and we evaluated some of the variables and clinical/surgical characteristics of the cases.The effects of the type of surgical procedure,surgical staging,and complete or incomplete staging on recurrence were calculated.The rates of disease-free survival,overall survival,and recurrence were compared according to complete surgical staging.A Cox regression analysis was performed to identify potential prognostic factors,and survival curves were constructed using the Kaplan-Meier method.Results:The overall recurrence rate was 13.9%,and recurrence was comparable between the complete surgical staging group and the incomplete groups(P>0.05).The performance of complete surgical staging did not show an effect on long-term survival,and complete surgical staging,omentectomy,and lymphadenectomy had no effect on recurrence.In multivariate analyses,only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs.Furthermore,we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics(FIGO)stage>Ⅰ(P=0.022).Conclusion:Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stageⅠ.It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs.However,it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance.

Identification of serous ovarian tumors based on polarization imaging and correlation analysis with clinicopathological features

Ovarian cancer is one of the most aggressive and heterogeneous female tumors in the world,and serous ovarian cancer(SOC)is of particular concern for being the leading cause of ovarian cancer death.Due to its clinical and biological complexities,ovarian cancer is still considered one of the most di±cult tumors to diagnose and manage.In this study,three datasets were assembled,including 30 cases of serous cystadenoma(SCA),30 cases of serous borderline tumor(SBT),and 45 cases of serous adenocarcinoma(SAC).Mueller matrix microscopy is used to obtain the polarimetry basis parameters(PBPs)of each case,combined with a machine learning(ML)model to derive the polarimetry feature parameters(PFPs)for distinguishing serous ovarian tumor(SOT).The correlation between the mean values of PBPs and the clinicopathological features of serous ovarian cancer was analyzed.The accuracies of PFPs obtained from three types of SOT for identifying dichotomous groups(SCA versus SAC,SCA versus SBT,and SBT versus SAC)were 0.91,0.92,and 0.8,respectively.The accuracy of PFP for identifying triadic groups(SCA versus SBT versus SAC)was 0.75.Correlation analysis between PBPs and the clinicopathological features of SOC was performed.There were correlations between some PBPs(δ,β,q_(L),E_(2),rqcross,P_(2),P_(3),P_(4),and P_(5))and clinicopathological features,including the International Federation of Gynecology and Obstetrics(FIGO)stage,pathological grading,preoperative ascites,malignant ascites,and peritoneal implantation.The research showed that PFPs extracted from polarization images have potential applications in quantitatively differentiating the SOTs.These polarimetry basis parameters related to the clinicopathological features of SOC can be used as prognostic factors.

Endocrine-Disrupting Chemicals: Possible Genesis of Ovarian Tumors

Background: Prolonged exposure to environmental toxicants like endocrine-disrupting chemicals has been linked to several ovarian pathologies. Exposure to endocrine-disrupting chemicals may start at any time of life from the fetal stage to adulthood resulting in various health complications The purpose of our study is to compare the concentration levels and association of benzopyrene, bisphenol A and genistein in patients with ovarian tumors and normal control group. We also sort to evaluate the predictive performance of benzopyrene, bisphenol A and genistein in patients with ovarian tumors. Methods: A case-control study was conducted for randomly selected participants involving 30 patients and 30 controls. 30 patients with radiologically diagnosed and histopathological confirmed ovarian tumors were included in the study between January 2022 and December 2022. Urine samples from each group were analyzed using liquid chromatography-mass spectrometry. Descriptive analysis for normally distributed continuous variables was done accordingly. Concentration levels of endocrine-disrupting chemicals were assessed using the Mann-Whitney test. The association of endocrine-disrupting chemicals with pathological ovarian tumors was analyzed using binary logistic regression. Evaluation of the diagnostic performance of endocrine-disrupting chemicals was analyzed using the ROC curve. Results: Overall, patients were significantly (P = 0.000) older than the healthy controls. Mean years (SD) were 36.7 (7.90) and 28.8 years (4.89) for patients and normal women respectively. Endometriomas had the highest incidence of 50%. The level of benzopyrene and bisphenol A in patients was significantly higher than those in the control group, while the level of genistein was significantly higher in normal controls. Benzopyrene and bisphenol A were significantly associated with ovarian cysts, and the incidence of pathological ovarian cysts was positively correlated to these EDCs, with OR value 64.79 (P = 0.005) for benzopyrene and 9.609 (P = 0.001) for bisphenol A. Genistein was significantly negatively correlated with the incidence of pathological ovarian tumors, with OR value of 0.153 (P = 0.007). Diagnostic performance on the AUC for benzopyrene, bisphenol A and genistein&l.

Develop a nomogram to predict overall survival of patients with borderline ovarian tumors

BACKGROUND The prognosis of borderline ovarian tumors(BOTs)has been the concern of clinicians and patients.It is urgent to develop a model to predict the survival of patients with BOTs.AIM To construct a nomogram to predict the likelihood of overall survival(OS)in patients with BOTs.METHODS A total of 192 patients with histologically verified BOTs and 374 patients with epithelial ovarian cancer(EOC)were retrospectively investigated for clinical characteristics and survival outcomes.A 1:1 propensity score matching(PSM)analysis was performed to eliminate selection bias.Survival was analyzed by using the log-rank test and the restricted mean survival time(RMST).Next,univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors.In addition,a nomogram model was developed to predict the 1-,3-,and 5-year overall survival of patients with BOTs.The predictive performance of the model was assessed by using the concordance index(C-index),calibration curves,and decision curve analysis(DCA).RESULTS For clinical data,there was no significant difference in body mass index,preoperative CA199 concentration,or tumor localization between the BOTs group and EOC group.Women with BOTs were significantly younger than those with EOC.There was a significant difference in menopausal status,parity,preoperative serum CA125 concentration,Federation International of gynecology and obstetrics(FIGO)stage,and whether patients accepted postoperative adjuvant therapy between the BOT and EOC group.After PSM,patients with BOTs had better overall survival than patients with EOC(P value=0.0067);more importantly,the 5-year RMST of BOTs was longer than that of EOC(P value=0.0002,95%CI-1.137 to-0.263).Multivariate Cox regression analysis showed that diagnosed age and surgical type were independent risk factors for BOT patient OS(P value<0.05).A nomogram was developed based on diagnosed age,preoperative serum CA125 and CA199 Levels,surgical type,FIGO stage,and tumor size.Moreover,the c-index(0.959,95%confidence interval 0.8708–1.0472),calibration plot of 1-,3-,and 5-year OS,and decision curve analysis indicated the accurate predictive ability of this model.CONCLUSION Patients with BOTs had a better prognosis than patients with EOC.The nomogram we constructed might be helpful for clinicians in personalized treatment planning and patient counseling.

Expression of Matrix Metalloproteinase-7 in Serous Ovarian Tumors

Objective:To explore the expression of matrix metalloproteinase-7 in serous ovarian tumors. Methods: Expression of MMP- 1 in 6 normal ovaries, 12 serous cystadenomas of ovary, 6 borderline cystadenomas of ovary, and 22 serous cystadenocarcinomas of ovary were studied by immunohistoc/temical SP staining. Results: No expression of MMP- 1 was detected in normal ovaries. In most serous ovarian tumors, expression of MMP-7 was detected in both the cytoplasm of tumor cells and stroma, although it was reported in other tumors that MMP- 7 was mainly expressed in the cytoplasm of tumor cells. The expression level of MMP-7 in the cytoplasm of tumor cells was statistically insignificant between serous cystadenomas of ovary, borderline cystadenomas of ovary, and serous cystadenocarcinomas of ovary. But in the stroma, the expression level of MMP-7 in borderline cystadenomas of ovary and serous cystadenocarcinomas of ovary was significantly higher than that in serous cystadenomas of ovary (P<0. 05). In borderline cystadenomas and serous cystadenocarcinomas of ovary, expression of MMP-7 could also be detected in the nuclei of some tumor cells. Conclusion: MMP-7 may play an important role in the progression of serous ovarian tumors.

MUTATIONAL SCREEN AT THE OEYTS-JEGHERS (LKB1) LOCUS IN SPORDIC COLON AND OVARIAN TUMORS

Objective: To screen LKB1 mutation in sporadic colon and ovarian tumors. Methods: Using PCR-SSCP analysis, 72 colon cancer, 45 ovarian cancer, 14 granulosa cell tumor were screened for LKB1 mutation. Results: no mutation was in sporadic colon and ovarian adenocarcinomas. Two mutations were detected in one of the granulosa cell tumors: a mis-sense mutation affecting the putative start codon (ATG→ACG, MIT); and a silent change in erxon 7 (CTT→CTA, leucine). Conclusion: LKB1 mutations in sporadic colon and ovarian cancers are rare event and LKB1 is not the target gene lost on chromosome 19p13.3 in ovarian cancers.

Clinical Presentation of Ovarian Tumors

Ovarian malignancy is a serious disease affecting women of all ages, more so above 50 years, and they are still difficult to treat, partly because no truly effective therapy has yet been developed although presentation is often vague and non-specific, the symptoms are definitely present. It is important to recognize the symptoms so far, there is no test yet available, which is truly specific and suitable for screening and early detection of epithelial ovarian carcinoma. So, it is concluded that for prognosis and patient survival, early detection and treatment is mandatory.

Expressions of Beta-catenin,E-cadherin and MMP-7 in Ovarian Epithelial Tumors

Objective： To investigate the expressions of Beta-catenin, E-cadherin and MMP-7 and their implications in ovarian epithelial tumor. Methods： Immunohistochemical staining with SP method was conducted to identify the expressions of Beta-catenin, E-cadherin and MMP-7 in ovarian epithelial tumor in 66 cases. Results： The abnormal expression rate of Beta-catenin in malignant ovarian epithelial tumor was higher than those in borderline and benign epithelial tumors （P〈0.05）. The positive rates of E-cadherin in benign and borderline ovarian epithelial tumors were significantly greater than that in malignant epithelial tumor. The expression rates of MMP-7 in malignant and borderline ovarian epithelial tumors were higher than that in benign epithelial tumor （P〈0.05）. Conclusion： The abnormal expressions of Beta-catenin, E-cadherin and MMP-7 might be used to indicate the malignance transform of ovarian epithelial tumors, but they have no significant correlation with peritoneal dropsy invasion, caul invasion and appendant invasion in ovarian epithelial tumor.

Oncology and reproductive outcomes over 16 years of malignant ovarian germ cell tumors treated by fertility sparing surgery

BACKGROUND Malignant ovarian germ cell tumors(MOGCT)are rare and frequently occur in women of young and reproductive age and the oncologic and reproductive outcomes after fertility-sparing surgery(FSS)for this disease are still limited.AIM To evaluate the oncology and reproductive outcomes of MOGCT patients who underwent FSS.METHODS All MOGCT patients who underwent FSS defined as the operation with a preserved uterus and at least one side of the ovary at our institute between January 2005 and December 2020 were retrospectively reviewed.RESULTS Sixty-two patients were recruited for this study.The median age was 22 years old and over 77%were nulliparous.The three most common histology findings were immature teratoma(32.2%),dysgerminoma(24.2%),and yolk sac tumor(24.2%).The distribution of stage was as follows;Stage I,74.8%;stage II,9.7%;stage III,11.3%;and stage IV,4.8%.Forty-three(67.7%)patients received adjuvant chemotherapy.With a median follow-up time of 96.3 mo,the 10-year progressionfree survival and overall survival were 82.4%and 91%,respectively.For reproductive outcomes,of 43 patients who received adjuvant chemotherapy,18(41.9%)had normal menstruation,and 17(39.5%)resumed menstruation with a median time of 4 mo.Of about 14 patients who desired to conceive,four were pregnant and delivered good outcomes.Only one case was aborted.Therefore,the successful pregnancy rate was 28.6%CONCLUSION The oncology and reproductive outcomes of MOGCT treated by FSS are excellent.Many patients show a long survival time with normal menstruation.However,the obstetric outcome is not quite satisfactory.

Premature Puberty Revealing an Ovarian Tumor in a Five-Year-Old Girl

Background: Ovarian tumors in the girl child are sometimes revealed by the development of secondary sexual characteristics. The authors report the case of a five-year-old girl in whom the disease was revealed by early puberty. Case presentation: A five-year-old girl with an enlarged abdomen for about four months. The onset of pain and the sensation of a mass prompted the consultation. The development of secondary sexual characteristics (SSC) noted by the family had not been mentioned. The patient was classified as pubertal stage 2 according to the Tanner classification. An abdominal ultrasound and a CT scan showed a large left ovarian mass, an enlarged uterus for the patient’s age and a normal right ovary. The hormonal workup was not contributive. The treatment consisted only of a left salpingo-ovarectomy, without complementary chemotherapy. Anatomic pathological examination of the surgical specimen concluded to a juvenile tumor of the granulosa. The evolution was good with a beginning of regression of the HSC one month after the ovarectomy. Discussion: Granulosa tumors are sometimes secretory cancers, generally with a low potential for malignancy and therefore a very good prognosis. Surgery based on total adnexectomy is the first-line treatment. The large size of the tumor, the presence of ascites and capsular rupture are factors of poor prognosis, hence the importance of early diagnosis. Conclusion: Routine comprehensive physical examination should be de rigueur for abdominal masses in girls, especially in the context of various beliefs that may impede early referral to care.

Cystic Degeneration of Uterine Leiomyoma Misdiagnosed as Ovarian Malignancy: A Case Report

Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5th post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.

A case of primary ovarian carcinoid and the review of the literature

Objective:To investigate the clinicopathologic features of primary ovarian carcinoid.Methods:A case of primary ovarian carcinoid of the ovary were reported.Clinicopathological analysis was performed.Results:The case was just an island-like carcinoid.The tumor cells were round or polygonal,arranged into island-like or pseudo chrysanthemum clusters,and got bilateral tubal and oophorectomy.No evidence of recurrence was consulted in 28 months of follow-up.Conclusion:Primary ovarian carcinoid is rare in clinic.The diagnosis should be differentiated from granulosa cell tumor and sertolithoid cell tumor,and metastatic carcinoid should be excluded.As a low-grade malignant tumor,most ovarian carcinoids have a real good prognosis.

Expression of MTA2 Gene in Ovarian Epithelial Cancer and Its Clinical Implication

In order to investigate the roles of MTA2 in the pathogenesis of ovarian epithelial cancer, the expression of MTA2 in 4 ovarian cell lines were detected by semi-quantitative RT-PCR and Western-blot assays. MTA2 expression in normal, borderline, benign and malignant epithelial ovarian tissues was immunohistochemically examined. The expression of MTA2 mRNA and protein was detected in all of 4 cell lines of ovarian epithelial cancer. The expression of MTA2 mRNA and protein was higher in strong migration cell lines than in weak migration ones. In borderline and ma lignant ovarian tissues tested, MTA2 staining was dramatically stronger than in normal and benign tissues （P〈0. 01）. The expression levels in malignant ovarian tissues were significantly higher than that in borderline epithelial ovarian tissues （P〈0.01）. The expression of MTA2 was correlated with clinical stage, histopathological grade and lymph node metastasis. It was concluded that the high expression of MTA2 was associated with more aggressive behaviors of epithelial ovarian cancer. MTA2 provides a novel indicator of ovarian cancer.

Expression of Wnt-1,beta-catenin and c-myc in Ovarian Epithelial Tumor and Its Implication

Objective： To investigate the expression of Wnt-1, beta-catenin and c-myc in normal ovarian epithelial cell and malignant ovarian epithelial tumor. Methods： Immunohistochemical staining with SP method was conducted to identify the expression of Wnt-1, beta-catenin and c-myc in 18 samples of normal epithelial tissue and 34 cases of malignant epithelial tumor of ovary. Results： The expression rate of Wnt-1 and c-myc in malignant epithelial tumors was higher than those in normal epithelial cell （P〈0.05）. The abnormal expression rate of beta-catenin in malignant ovarian epithelial tumors was higher than that in normal epithelial cell （P〈0.05）. A significant positive correlation was found between Wnt-1, beta-catenin and c-myc in malignant ovarian epithelial tumor （P〈0.05）. A significant difference of expressions of Beta-catenin and C-myc was found between serous and mucinous tumors （P〈0.05）. Conclusion： The abnormal expression of Wnt-1, beta-catenin and c-myc might indicate the malignant transformation in ovarian epithelial tumors.

Expressions of beta-catenin, APC Protein, C-myc and Cyclin D1 in Ovarian Epithelial Tumor and Their Implication

Objective： To investigate the expressions of beta-catenin, protein APC （adenomatous polyposis coil protein）, c-myc and cyclin D1 and their implication in ovarian epithelial tumor. Methods： Immunohistochemical staining with SP method was conducted to identify the expressions of beta-catenin, APC protein, c-myc and cyclin D1 in ovarian epithelial tumor in 48 cases. Results： The abnormal expression rate of beta-catenin in malignant and borderline ovarian epithelial tumors was higher than that in benign epithelial tumors （P〈0.01）. The expression rates of c-myc and cyclin-D1 in ovarian malignant and borderline epithelial tumors were higher than those in benign epithelial tumors too（P〈0.05）. The prevalence of APC protein positive expression in benign epithelial tumors were significantly greater than that in malignant epithelial tumors （P〈0.05）. A significant negative correlation was found between beta-catenin and APC protein in ovarian epithelial tumors; while a significant positive correlation was found between beta-catenin, c-myc and cyclin-D1 in ovarian epithelial tumor （P〈0.05）. Conclusion： The abnormal expressions of Beta-catenin, APC protein, c-myc and cyclin-D1 might be used to indicate the malignance transform of ovarian epithelial tumors.

Study on Tumor Angiogenesis in Epithelial Ovarian Carcinoma

To investigate tumor angiogenesis in benign, borderline and malignant epithelial ovarian tumors and its relation with the pathogenesis of ovarian carcinoma, polycolonal antibody directed against human von Willebrand factor (factor Ⅷ ) was used to measure the microvessel density (MVD) in 66 cases (11 benign, 10 borderline, and 45 malignant) of epithelial ovarian tumors by using immunohistochemistry. The results showed that the mean MVD in epithelial ovarian cancer (31. 7 ± 11. 2, 400 × ) was higher than in benign and borderline tumors (16. 7± 6. 3, 20. 7± 8. 8 respectively, P<0. 05). There was no difference in MVDs among those in different tumor grades (P>0. 05). But there was significant difference in MVDs among those in different tumor stages (P< 0. 05). MVD in stage Ⅲ - Ⅳ cancer was higher than that in stage Ⅰ - Ⅱ (P<0. 05). It is concluded that the tumor angiogenesis is an early event in ovarian tumorgenesis. The increased tumor micovessel might be responsible for tumor development.

Detection of Laminin in Serum and Ascites from Patients with Epithelial Ovarian Tumor

The change in serum laminin (LN) level and its clinical significance in epithelial ovarian tumor were investigated. The LN levels in serum and ascites samples from 69 patients with epithelial ovarian tumor and 42 cases as control group before and after operation were analyzed by radioimmunoassay. The results showed that the serum LN levels in the patients with malignant tumors (157.85 ±14.37 ng/ml) were significantly higher than that in the control group (125.14 ±7.03 ng/ml) and in the patients with benign tumors (128.36±8.75 ng/ml)(both P <0.01) before operation. The serum LN levels in the malignant group were decreased significantly after operation as compared with those before operation ( P <0.05). The serum LN levels in low differentiated tumors was higher than those in moderate differentiated tumors and high differentiated tumors ( P <0.05). The LN levels in ascites (172.94±15.26 ng/ml) was significantly higher than in serum (161.34±6.59 ng/ml)( P <0.05) in malignant tumors. The serum LN levels in the patients with lymph node metastasis (165.41±19.91 ng/ml) was obviously higher than those without lymph node metastasis (152.35±10.34 ng/ml)( P <0.05). It was concluded that LN levels in serum and acistes were remarkably increased in malignant epithelial ovarian tumors, suggesting that LN might be one of important diameters reflecting tumor biological characteristics.

Construction of Antisense MT1-MMP Vector and Its Inhibitory Effects on Invasion of Human Ovarian Cancer Cells

Membrane-type 1 matrix metalloproteinase （MT1-MMP/MMP-14） plays crucial roles in tumor cell growth, invasion, and angiogenesis. To clarify whether the endogenously expressed MT1-MMP in metastatic human ovarian carcinoma cell lines SKOV3 plays a critical role in tumor cell invasiveness, antisense MT1-MMP cloned in eukaryotic expression vector pMMP14as was transferred into SKOV3 cells. 48h after transfection, decreased expression of endogenous MT1- MMP protein was detected in pMMP14as-transfected SKOV3 cells and the activation of pro-MMP2 was inhibited markedly. The mean percentage of invasive cells was （62. 50 ± 5. 30） % in pMMP14as-transfected cells, which was obviously less than that （97.20±6.90） % in the control. Thus, antisense MT1-MMP effectively inhibited the endogenous MT1-MMP expression and the invasiveness in SKOV3 cells, suggesting that MT1-MMP may be a therapeutic target molecule for human invaslve ovarian cancers.

CLINICAL DIAGNOSIS AND TREATMENT OF SMALL OVARIAN TUMOR IN POSTMENOPAUSAL WOMEN

Objective： To investigate the clinical symptom, ultrasonographic scan finding, serum CA125 value, histopathological type and treatment of small ovarian tumor （〈5 cm） in postmenopausal women. Methods： Retrospective analysis was carried out for 52 clinical materials of ovarian tumor cases in women more than one year after menopausal between Jan 1997 and Dec 2004. The largest diameter of the ovarian mass is less than 5 cm. Results： There were 11 ovarian cancers and 1 borderline ovarian tumor among 52 small ovarian tumors （23.1%）. 10 ovarian cancers were epithelial neoplasms and 2 were sex cord-stromal tumors, and 8 cases were in late stage according to FIGO staging system （33.3%）. Compared with benign tumor, there is no significant difference in the onset age, interval after menopausal and duration of history. The main clinical feature is abdominal symptoms, such as abdominal pain and distension in the malignant cases. The patients with benign tumors often showed the ovarian mass during the annual screening or admitted into hospital for other causes. The ultrasonography finding and serum CA125 level showed much difference between benign and malignant cases. Unilocular smooth-walled ovarian cysts mostly were found in benign tumor and the CA125 values were always less than 35 U/ml; but the solid or complex sonographic structures （multilocular, or with a papillary projections on the wall） often indicated a high risk of cancer, especially there was ascites in the pelvic cavity. Serum CA125 level in many cancer cases was elevated （〉35 U/ml）, over 300 U/ml in more than half of the patients. Surgery is still the first choice to treat ovarian cancer, and chemotherapy would be an auxiliary method. Till now, 3 ovarian cancer patients died of complications of cancer and 2 cases had recurrence. Conclusion： Small ovarian tumor in postmenopausal women has a comparatively low malignant occurrence but more in later stage. Many are epithelial carcinoma. If there is complex or parenchymal sonographic structure accompanied with a high serum CA125 level, operation should be considered, while it can be followed up when the ultrasound shows a smooth cyst with normal CA125 value.