A 60-year-old woman with no known medical history presented to the emergency department with 5 days of constipation and lower abdominal cramping. She reported nausea and 1 episode of nonbloody, nonbilious emesis, along with a 50-lb weight loss, which she attributed to lifestyle changes. Physical examination revealed suprapubic tenderness, right abdominal distension, and mild lower extremity edema. Computed tomographic findings (images A and B) revealed a large cystic mass arising from the pelvis and extending into the abdomen, with multiple septations. The patient underwent resection of 2 separate masses. Pathologic testing identified a benign ovarian cystadenoma. On follow-up, the patient's symptoms had resolved. 

A gynecological mass can often be grouped based on a patient's reproductive status and age. In women of reproductive age, the most common benign neoplasms are cystadenomas and mature cystic teratomas.¹ At least 30% of ovarian masses in postmenopausal women are malignant.²