25 malignant cases (19.3%) (malignant group; MG), with a mean age of 58 ± 20. The mean age of the patients with benign cysts (benign group; BG) was 44.8 ± 16 and the difference was statistically significant (p < 0.001). Malignant cases were significantly more prevalent among post-menopausal women (68% versus 38%, P = 0.006). Comparison of US parameters between the groups revealed no significant difference between BG and MG groups regarding the size of the lesion (7.3 versus 8.4 cm; p = 0.331) and bilaterality (23% versus 17%; p = 0.782). Patients in the MG had more complex lesions (96% versus 61%; p < 0.001), free fluid in the pelvis (73% versus 22%; p ≤ 0.001) and higher CA125 levels (eta correlation coefficient 0.941). Presence of free fluid in the pelvis had the highest correlation with malignancy (phi = 0.416). Conclusions: Although expert opinion and Risk of Malignancy Indices are the state of the art in predicting ovarian malignancy, the combination of basic ultrasound findings and CA125 levels have significant benefit in the patient work-up and planning of the best intervention.
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