Ovarian Cyst

Question 1

What is an ovarian cyst?

Answer 1

Fluid filled sac in the ovaries

Question 2

How can ovarian cysts present?

Answer 2

• pelvic pain
• bloating
• fullness in the abdomen
• palpable pelvic mass

Question 3

How do the majority of ovarian cysts present?

Answer 3

• Asymptomatically and found incidentally on pelvic ultrasound scans

Question 4

What are the different types of ovarian cyst?

Answer 4

Physiological cysts
Dermoid
Benign epithelial tumours
Benign sex cord stromal tumour

Question 5

What type of cysts are physiological cysts?

Answer 5

Functional cysts

Question 6

What are the 2 main types of physiological cyst?

Answer 6

Follicular cysts
Corpus luteum cysts

Question 7

What is the most common type of ovarian cyst?

Answer 7

Follicular cyst

Question 8

What can happen to follicular cysts after a few menstrual cycles?

Answer 8

They usually regress

Question 9

What is another term for dermoid cysts?

Answer 9

Benign germ cell tumours

Question 10

What are dermoid cysts?

Answer 10

Mature cystic teratomas

Question 11

What are dermoid cysts the most common form of?

Answer 11

Benign ovarian tumour in woman under the age of 30 years

Question 12

When are dermoiid cysts usually diagnosed?

Answer 12

At around 30 years of age

Question 13

How do dermoid cysts usually present?

Answer 13

Asymptomatically

Question 14

What can dermoid cysts contain?

Answer 14

They are lined with epithelial tissue and may contain skin appendages, hair and teeth

Question 15

What are dermoid cysts associated with?

Answer 15

Ovarian torsion

Question 16

What imaging can be used in the diagnosis of ovarian cysts?

Answer 16

Ultrasound

Question 17

What is the management of a premenopausal women with a simple ovarian cyst <5cm on ultrasound?

Answer 17

No further investigation required

Question 18

What would you look for in the blood of someone with an ovarian cyst?

Answer 18

CA 125

Question 19

What is the management of a simple cyst less than 5cm?

Answer 19

Shoudl resolve in 3 menstrual cycles

Question 20

What is the management of an ovarian cyst between 5-7cm?

Answer 20

Routine referral to gynaecology and yearly ultrasound monitoring

Question 21

What is the management of a simple cyst more than 7cm?

Answer 21

Consider MRI or surgical evaluation as they can be difficult to characterise on ultrasound

Question 22

What is the initial management of a dermoid cyst?

Answer 22

Referral to gynaecology for further assessment and consideration of surgery

Question 23

What surgery can be carried out for a dermoid cyst?

Answer 23

Ovarian cystectomy, and possible oophorectomy

Question 24

What is the management of a complex
Complex i.e. multi-loculated ovarian cyst?

Answer 24

Biopsy to exclude malignancy.

Question 25

What can cause an ovarian cyst to rupture?

Answer 25

Physical activity

Question 26

What are possible differentials of ovarian cyst rupture?

Answer 26

Ovarian torsion
Ectopic pregnancy
Appendicitis

Question 27

How can an ovarian cyst rupture present?

Answer 27

Asymptomatic
Acute unilateral pain
to
Intra-peritoneal haemorrhage with haemodynamic compromise.

Question 28

How can an ovarian cyst rupture be diagnosed?

Answer 28

Diagnostic laparoscopy