Version June 2024
| Sonographic appearance and specific etiologies | Malignant? |
| Simple cysts | |
| Non-neoplastic physiologic cyst (dominant follicle, arrested follicle, corpus luteum) | No |
| Paraovarian or paratubal cyst | No |
| Cystadenoma (ovarian or tubal) | No |
| Anechoic cysts with thin septations (complete or incomplete) | |
| Two adjacent non-neoplastic physiologic cysts | No |
| Paratubal cyst | No |
| Hydrosalpinx | No |
| Peritoneal inclusion cyst | No |
| Theca lutein cysts | No |
| Cysts with internal echoes, no solid areas | |
| Non-neoplastic physiologic cyst with hemorrhage | No |
| Endometrioma | No |
| Abscess (gynecologic or gastrointestinal) | No |
| Benign ovarian neoplasm (eg, cystadenoma, cystic teratoma) | No |
| Borderline ovarian tumor | Yes |
| Gastrointestinal (duplication cyst, mucocele) | Usually not (mucoceles may be malignant) |
| Cysts with solid-appearing areas (including irregularly thick septations and walls or septal/mural nodules) | |
| Corpus luteum | No |
| Mature cystic teratoma | No |
| Cystadenofibroma (ovarian or tubal) | No |
| Cystadenocarcinoma (ovarian or tubal, including borderline tumors) | Yes |
| Ectopic pregnancy | No |
| Mostly or completely solid mass | |
| Adnexal torsion | No |
| Leiomyoma (pedunculated or broad ligament) | No (but rarely may be a sarcoma) |
| Epithelial ovarian or tubal carcinoma | Yes |
| Ovarian sex cord-stromal tumors (eg, fibroma, Sertoli-Leydig, thecoma) | May be benign or malignant |
| Ovarian germ cell tumors (eg, teratocarcinoma, struma ovarii) | May be benign or malignant |
| Metastasis to ovary | Yes |
| Nongynecologic primary tumor (gastrointestinal, neurogenic, lymphoma) | Some |
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