Ovarian/Vulval Cysts

Question 1

How common?

Answer 1

Exceptionally common

Question 2

How do they appear on TVUS?

Answer 2

Areas of fluid are seen

Question 3

If pre-menopausal woman presents with complex cysts what further invx should be done?

Answer 3

HCG
a-FP
CA125

To rule out malignancy (germline cell tumour - HCG and a-FP)

Question 4

Would a patient have raised HCG and a-FP if they have dermoid cyst/teratoma?

What is this?

Answer 4

No

Benign germline cell tumour - can manifest to have skin, hair and teeth in it

Question 5

How can they present?

Answer 5

~ painful

Abdo/pelvic mass

Question 6

what are the complications?

Answer 6

Can haemorrhage

Can undergo torsion - esp. dermoid cysts

Question 7

What are Bartholian’s cysts?

They are normally only pea sized but can become larger when infected - how are they then managed?

Answer 7

Cysts which are found at 5 and 7 o’clock position at vaginal orifice

With antibiotics or may require marsupialization (where it is opened up to allow drainage)