Adnexal Mass under evaluation

19 yr old unmarried girl presented with abdominal pain with no other complaints. clinical examination mass palpable per abdomen upto umbilicus with restricted mobility, minimal tenderness, no free fluid. On ultrasound mass from right adnexa 15*15 cm noted with retroperitoneal extension. Kindly opine on further management. Thanking you.

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As its solid mass high probablity of melignency.. Ovarian tumor. ?
May be we can start thinkg of surgical differential. Might be appendicular mass. Appendicula abscess. Ca cecum. Ca ascending colon. AAA. GYNECOLOGICAL. may be Twisted ovarian mass. Tuboovarian abscess. Ovarian Ca. Serosal Fibroid. HCG CA- 125. BRCA 1 FIBRONECTIN I suggest explorative laparatomy
CT abdo-pelvis to rule out ovarian malignancy as CA-125 levels are within normal range then plan for exploratory laprotomy .
Then it is malignant side as it is above normal range
Rightsided ovarian tumor Adv Ca125
Ovarian torsion
CA 125 is 38