Ovarian Cysts Flashcards
What are the three types of ovarian cysts?
- Physiological cysts
- Benign germ cells
- Benign epithelial
How common are ovarian cysts and when do they become concerning?
- Extremely common
2. If >5cm, if TVUSS shows complex/suspicious features, or if they are symptomatic.
What are the most common type of ovarian cyst and what makes them regress?
- Follicular cyst
2. Regress after several menstrual cycles
Which type of ovarian cyst is described?
Causes increased progesterone, delay in menstruation, and heavy periods.
Corpus luteal cyst
What is this a presentation of?
Chronic dull ache, dyspareunia, cyclical pain, ‘bloating’, change in bowel habit, frequency. Or acute pain, ovarian torsion, or rupture.
Ovarian cyst
How are ovarian cysts investigated?
- TVUSS 1st line
- Check FBC and tumour markers CA125, bHCG, AFP, LDH in >40 years.
- MRI if worrying features on USS - solid areas, metastases, ascites.
What is the management for ovarian cysts with acute onset symptoms and severe pain?
- Admit
- Unstable - urgent diagnostic laparoscopy (could be ectopic)
- Stable - TVUSS
What is the management for ovarian cysts in pre-menopausal women?
- Rescan in 6 weeks if TVUSS shows no worrying features
- No intervention if <5cm and asymptomatic
- If >5cm/symptomatic/dermoid cyst - laparoscopic cystectomy
What is the management for ovarian cysts in post-menopausal women?
- Calculate RMI score
- Low risk - repeat TVUSS and CA125 every 4 months and discharge after 1 year if no change
- Moderate risk - bilateral oophorectomy
- High risk - refer to cancer centre for staging laparotomy
What is this a presentation of?
Uncommon, severe lower abdominal pain and vomiting, presents similar to cyst rupture +/- haemorrhagic shock.
Ovarian torsion
How is ovarian torsion managed?
Laparoscopy
