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A high index of suspicion for possible malignancy is necessary. Indications for exploratory laparotomy are discussed in the appropriate section and should be accompanied by the collection of any ascitic fluid and washings from the pelvis, both paracolic gutters and both hemidiaphragms.

If there is any doubt as to whether the tumour is malignant, the whole ovary should be removed and a frozen section of the tumour examined histopathologically with a view to proceeding surgically for carcinoma.

Cystectomy - enucleation of the cyst from the ovary - is usually performed in young patients if future fertility is required, and the tumour appears benign.

In postmenopausal women, total abdominal hysterectomy and bilateral salpingo-oophorectomy are appropriate.

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