What is the most likely diagnosis for a palpable right adnexal mass in a 72-year-old post-menopausal woman?

In a 72-year-old post-menopausal woman presenting with a palpable right adnexal mass, the most likely diagnosis is ovarian cancer. This demographic represents a group at higher risk for ovarian malignancies, particularly due to age and the post-menopausal status, as the incidence of ovarian cancer increases significantly with age. The presence of an adnexal mass, especially in a woman who is post-menopausal, raises suspicion for a neoplastic process rather than benign conditions.

Ovarian cancer can often be asymptomatic in the early stages, but as it progresses, it may present with abdominal discomfort, bloating, and changes in bowel habits, in addition to a palpable mass. It’s crucial to consider malignancy in older women, particularly if they are experiencing any new-onset symptoms.

Endometriomas, associated with endometriosis, and functional ovarian cysts are more common in younger women who are pre-menopausal and are less likely to occur in someone who has already undergone menopause, making them less probable in this scenario. Uterine cancer typically presents with different symptoms, such as abnormal vaginal bleeding rather than a palpable adnexal mass.

Thus, in this clinical context, the characteristics of the presented mass, in conjunction