The main symptom of malignant transformation of ovarian cysts is increased abdominal pain, which generally occurs on one side, including either the left or right side, since the ovaries are present on both sides. If the cyst is unilateral, rapid growth can cause lower abdominal distension and pain. Therefore, when such symptoms aggravate, timely examination is necessary. Initially, a gynecological examination is recommended to assess the boundaries of the ovarian cyst and to palpate its nature and texture. These are essential evaluations. If there is a potential for malignancy, sometimes nodular changes, which may be metastases, can be detected in the posterior cul-de-sac. Subsequently, an ultrasound should be performed, with vaginal ultrasound generally providing greater accuracy.