ovarian%20mass
OVARIAN MASS
Ovarian cysts are typically noted after clinical screening, or as a result of exam for a suspected pelvic mass, or an incidental finding in investigations done for other reasons.
Most ovarian masses manifest with few or mild nonspecific symptoms.
Ovarian masses in women of reproductive age are mostly benign but the risk of malignancy increases with age.
Ovarian cysts in the prepubertal patients especially after the first week of life are abnormal and likely to be neoplastic. In adolescent patients, majority of ovarian masses are functional cysts.

Monitoring

Postmenopausal Woman 

  • Small (<5 cm), simple, unilocular, unilateral ovarian cysts in asymptomatic patients can be followed conservatively
  • Repeat transvaginal ultrasound and serum CA-125 should be performed at 3- to 4-month intervals x 1 year to check for any change in size or development of suspicious features
    • 50% of asymptomatic cysts resolve within 2 months
  • Consider surgical management for women with moderate- to high-risk Risk of Malignancy Index (RMI) or for those who do not qualify for conservative management

Conservative Management

  • Asymptomatic, simple, unilateral, unilocular ovarian cysts <3-5 cm in diameter have a low risk of malignancy and if CA-125 is normal, the woman may be managed conservatively

Expectant Management in Premenopausal Patient

  • Conservative observation can be adopted for complex or solid ovarian cysts of benign character (<8 cm in diameter, unilateral, unilocular, cystic, mobile, smooth, solid component is <7 mm, positive acoustic shadowing, absent blood flow) with ultrasound surveillance every 2-3 months
  • Follow-up is not required for simple ovarian cysts <5 cm as it usually spontaneously resolves, follow-up with ultrasound every 3-4 months for 5- to 7-cm cysts, and consider further imaging or surgical referral for larger simple cysts
    • Laparoscopic cystectomy may be done if surgery is required
  •  70% of benign ovarian masses will resolve spontaneously by either reabsorption of the cyst fluid or silent rupture within 4-8 weeks of initial diagnosis
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
6 days ago
The aromatase inhibitor anastrozole shows promise in the treatment of children with congenital adrenal hyperplasia, reducing bone age advancement without adversely affecting bone mineral density and visceral adipose tissue, as shown in a recent study.
5 days ago
The choice between nonvitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) for stroke prevention appears to be complex and largely heterogenous across different, countries, a new study has found.
13 Jun 2019
Response to desmopressin treatment for nocturnal enuresis in children appears to be compromised in the presence of constipation, particularly in children with severe enuresis and those prescribed low doses, as reported in a recent study.
14 Jun 2019
Elevated serum urate concentrations may be protective against dementia, regardless of subtype, reports a recent study.