Unknown ovarian mass – concerned

Patient: Hello, I am a 23 year old who has recently been having problems related to a mass found in my left ovary at the end of June. I had initially gone to my GP regarding my irregular periods. They have been irregular for about 7 Years, I’d estimate. As time had progressed, I’d started go longer lengths of time between periods, and at the time I’d gone to my GP in June, it had been 8 months to a year since many last period. My GP suspected that I may have PCOS, as I have many other symptoms related to it. Around the same time that my periods began becoming irreguar, I also started gaining weight and growing unwanted facial hair. I thought nothing of it at the time except that maybe it was just a part of puberty and I’d grow out of it. The weight and facial hair got worse, and many periods became increasingly irregular, so about5 years ago I got tested for PCOS. They said many ovaries were fine and recommended birth control to regulate my hormones, sayng that an imbalance was likely causing my problems. I decided not to take the pill, because i did not want to gain more weight. Things have gotten worse since then. After going to my GP last month, she scheduled me to have a transvaginal ultrasound to see if there were signs of polycystic ovaries. The ultrasound was the WORST pain I have experienced in my life, which the radiologist told me was not normal, i am not sexually active. The US did not find polycystic ovaries, but instead found a 6cm mass near my left ovary. My left ovary was not visible, presumably because the mass is covering it. The mass was initially thought to be a benign dermoid, but I w scheduled to have a CT scan for a second look. The results of the CT scan were bothersome, i was told that the CT could not determine whether the mass was in fact a dermoid, so they we essentially back to square one. My GP says they do not know what it is set all. They don’t know if it’s a cyst or a tumor, benign or malignant. She outs now sending me to an obgyn for further evaluation. She did say that due to the size of the mass, it is likely that it’s been there for quite a while. I figure if it’s been there a while and hasn’t caused me any pain or other problems yet, it probably isn’t cancerous, but I am still worried that maybe it is cancerous, and that I’ve waited to long to get it checked out. I have no symptoms, other than those present with PCOS and Hormonal imbalance, so that makes me think it’s benign. But is it possible that this could be cancer? My other hypothesis is that I’ve just had a hormonal imbalance for years that I never really did anything about, so my lack of ovulation from the imbalance of hormones could have caused the cyst to appear. I feel like that is a lot more likely, but I am still concerned. What could cause an ovarian mass with no symptoms other than the same ones I’ve been having for years?