Ct scan showed upper left adnexal cystic mass 4.2x3.2x4.2cm with thickened enhancing rim. physical exam did not feel mass, still have abdominal pain?

See a gynecologist: While many of these masses are benign without pain, it is quite possible to have something more serious without pain. See your gynecologist and obtain a transvaginal ultrasound for better definition of the mass and obtain proper bloodwork your gynecologist is likely to recommend.

This needs attention: When did you perform the ct? In your age group (assuming post menopausal) this complex appearing cyst could be any thing including an ovarian neoplasm. If this cyst persists and / or increases in size, it will need further evaluation and work up. Contact your gynecologist to discuss more.