ovarian cysts Flashcards
cyst
fluid filled sac
functional ovarian cysts
related to the fluctuating hormones of menstrual cycle
very common in premenopausal women
cysts in premenopausal women
vast majority are benign
cysts in postmenopausal women
more concerning for malignancy and need further Ix
presentation
incidental finding on USS pelvic pain bloating feeling fullness palpable mass
types of functional cysts
follicular
corpus luteum cysts
follicular cysts
follicle fails to rupture and release egg, can persist asa cyst
most common type of cyst
harmless and tend to dissapear after a few cycles
follicular cyst USS findings
thin walls
no internal structures
corpus luteum cysts
corpus luteum fails to breakdown and fills with fluid
pelvic discomfort, pain, delayed menstruation
often seen in early pregnancy
serous cystadenoma
benign tumours of epithelial cells
mucinous cystadenoma
benign tumours of epithelial cells
can become huge and take up lots of space
dermoid cysts/germ cell tumours
benign ovarian tumours
teratomas and may contain various tissue types
sex cord stromal tumours
rare tumours, can be benign or malignant
arise from stroma or sex cords
assess for risk factors for ovarian malignancy
age post menopause inc number ovulations obesity HRT smoking FHx BRCA1 BRCA2
Ix - premenopausal women with simple cyst <5cm
no further Ix
Ix - women under 40 with complex mass
LDH
alpha-fetoprotein
hCG
causes of raised CA125
endometriosis fibroids adenomyosis PID liver disease pregnancy
risk of malignancy index
menopausal status
USS findings
CA125
Mx - possible caner
(complex cyst or raised CA125)
2wk wait referral to gynae oncology
Mx - possible dermoid cyst
gynae referral for further Ix and consideration of surgery
Mx - simple cyst in premenopausal women
< 5cm - no follow up
5-7cm gynae referral, yrly USS
> 7cm - MRI
Mx - cyst in postmenopausal women
if raised CA125 - 2wk referral
<5cm and normal CA125 = monitor 4-6mo USS
main complications
torsion
haemorrhage into cyst
rupture
Meig’s syndrome
ovarian fibroma
pleural effusion
ascites
