Indeterminate Ovarian Lesion
An indeterminate ovarian lesion is an abnormal finding on imaging that cannot be clearly classified as benign or malignant based on its current appearance. These lesions may represent a functional cyst, hemorrhagic cyst, endometrioma, dermoid, benign tumor, or, less commonly, an ovarian cancer. Because the imaging features are unclear or incomplete, further evaluation or follow-up is often required.
What is it?
An indeterminate ovarian lesion refers to any ovarian abnormality that does not have enough defining features on imaging to categorize it confidently. Causes may range from benign functional cysts and hemorrhagic cysts to endometriomas, dermoid cysts, or early ovarian tumors. Some lesions appear partly solid or complex, or are too small or subtle to characterize reliably.
Ultrasound is the primary tool used to assess ovarian lesions, with MRI often recommended for further evaluation when features remain unclear. Radiologists evaluate components such as septations, nodules, blood flow, and internal echoes to help determine the most likely diagnosis.
Important to Know
Most indeterminate ovarian lesions are ultimately benign. However, because ovarian cancer can present subtly, any lesion with uncertain or suspicious features requires careful follow-up. Age, symptoms, and specific imaging findings help guide next steps.
Red flag symptoms include persistent or worsening pelvic pain, early satiety, bloating, sudden severe pain (possible cyst rupture or torsion), or unexplained weight loss. Follow-up imaging—often within a few months—is commonly recommended, especially if the lesion is complex or has solid components.