Summary
Definition
Ovarian cyst is a surgical, imaging, or examination finding of an enlarged, fluid-filled ovary or portion of ovarian tissue. Ovarian cysts imply a pathophysiological process involving the ovary itself.[Figure caption and citation for the preceding image starts]: Laparoscopic view of ovarian cyst in vivoFrom the collection of Professor Michael Hopkins [Citation ends].
History and exam
Key diagnostic factors
- presence of risk factors
Other diagnostic factors
- pelvic pain
- bloating and early satiety
- palpable adnexal mass
Risk factors
- pre-menopausal age group
- early menarche
- first trimester of pregnancy
- personal history of infertility or polycystic ovary syndrome
- increased intrinsic or extrinsic gonadotrophins
- tamoxifen therapy
- smoking
- personal or family history of endometriosis
Diagnostic investigations
1st investigations to order
- transvaginal ultrasonography
Investigations to consider
- serum cancer antigen (CA)-125
- colour power Doppler ultrasonography of abdomen/pelvis
- MRI of abdomen/pelvis
- CT imaging of abdomen/pelvis
- karyotype analysis
- laparoscopy/laparotomy and histopathology
Emerging tests
- PET imaging of abdomen/pelvis
- serum biomarkers (ovarian adnexal mass assessment score test system)
Treatment algorithm
acutely ill
non-pregnant: pre-menopausal with simple ovarian cyst
non-pregnant: pre-menopausal with complex ovarian cyst
non-pregnant: pre-menopausal with solid ovarian cyst
post-menopausal with simple ovarian cyst
post-menopausal with complex ovarian cyst
post-menopausal with solid ovarian cyst
pregnant
Contributors
Authors
Sareena Singh, MD
Assistant Professor
Department of Obstetrics and Gynecology
Northeast Ohio Medical University
Rootstown
OH
Director of Gynecologic Oncology
Aultman Health Foundation
Canton
OH
Disclosures
SS declares that she has no competing interests.
Acknowledgements
Dr Sareena Singh would like to gratefully acknowledge Dr Michael P. Hopkins, Dr Christina N. Kufel, Dr Lauren M. Blue, Dr Jay R. Patibandla, and Dr Laura K. Randolph, previous contributors to this topic.
Disclosures
MPH, CNK, LMB, JRP, and LKR declare that they have no competing interests.
Peer reviewers
John Bachman, MD
Consultant in Family Medicine
Parker D Sanders and Isabella Sanders Professor of Primary Care
Rochester
MN
Disclosures
JB declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Disclosures
DC declares that he has no competing interests.
T. Justin Clark, MD (Hons), MRCOG
Consultant Obstetrician and Gynaecologist
Birmingham Women's Hospital
Obstetrics and Gynaecology
Birmingham
UK
Disclosures
TJC declares that he has no competing interests.
Differentials
- Ovarian cancer
- Ovarian torsion
- Polycystic ovary syndrome
More DifferentialsGuidelines
- Initial investigation and management of benign ovarian masses
- Simple adnexal cysts: SRU consensus conference update on follow-up and reporting
More GuidelinesPatient leaflets
Ovarian cyst
Ovarian cancer
More Patient leaflets
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