Diagnosis of cyst in premenopause

Question 1

Tumor markers to do in all women under 40 with complex cysts

Answer 1

• Lactate dehydrogenase (LDH)
• α-FP
• hCG

Question 2

Ca 125 and cysts in premenopause

Answer 2

• Only raised in grade III and IV endometriosis

- Only raised in 50 % of primary ovarian malignancies

Question 3

Facts on Ca125 and cysts in premenopause

Answer 3

• A serum CA-125 assay is not necessary when a clear ultrasonographic diagnosis of a simple ovarian cyst has
  been made
• If a serum CA-125 assay is raised and less than 200 units/ml, further investigation may be appropriate to
  exclude/treat the common differential diagnoses
• When serum CA-125 levels are raised, serial monitoring of CA-125 may be helpful as rapidly rising levels are more likely to be associated with malignancy than high levels which remain static
• If serum CA-125 assay more than 200 units/ml, discussion with a gynaecological oncologist is recommended