Resumo
Definition
Ovarian cyst is a surgical, imaging, or exam finding of an enlarged, fluid-filled ovary or portion of ovarian tissue. Ovarian cysts imply a pathophysiologic 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
Other diagnostic factors
- pelvic pain
- bloating and early satiety
- palpable adnexal mass
Risk factors
- premenopausal age group
- early menarche
- first trimester of pregnancy
- personal history of infertility or polycystic ovary syndrome
- increased intrinsic or extrinsic gonadotropins
- tamoxifen therapy
- smoking
- personal or family history of endometriosis
Diagnostic tests
1st tests to order
- transvaginal ultrasonography
Tests to consider
- serum cancer antigen (CA)-125
- color 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)
Algoritmo de tratamiento
acutely ill
nonpregnant: premenopausal with simple ovarian cyst
nonpregnant: premenopausal with complex ovarian cyst
nonpregnant: premenopausal with solid ovarian cyst
postmenopausal with simple ovarian cyst
postmenopausal with complex ovarian cyst
postmenopausal with solid ovarian cyst
pregnant
Colaboradores
Autores
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
Divulgaciones
SS declares that she has no competing interests
Agradecimientos
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.
Divulgaciones
MPH, CNK, LMB, JRP, and LKR declare that they have no competing interests.
Revisores por pares
John Bachman, MD
Consultant in Family Medicine
Parker D Sanders and Isabella Sanders Professor of Primary Care
Rochester
MN
Divulgaciones
JB declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Divulgaciones
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
Divulgaciones
TJC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology. Practice bulletin no. 174: evaluation and management of adnexal masses. Obstet Gynecol. 2016 Nov;128(5):e210-6. Resumen
DePriest PD, Shenson D, Fried A, et al. A morphology index based on sonographic findings in ovarian cancer. Gynecol Oncol. 1993 Oct;51(1):7-11. Resumen
American College of Obstetricians and Gynecologists. Committee opinion no. 716: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Sep 2017 (reaffirmed 2024) [internet publication].Texto completo
US Preventive Services Task Force; Grossman DC, Curry SJ, Owens DK, et al. Screening for ovarian cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Feb 13;319(6):588-94. Resumen
Levine D, Patel MD, Suh-Burgmann EJ, et al. Simple adnexal cysts: SRU consensus conference update on follow-up and reporting. Radiology. 2019 Nov;293(2):359-71.Texto completo Resumen
Grimes DA, Jones LB, Lopez LM, et al. Oral contraceptives for functional ovarian cysts. Cochrane Database Syst Rev. 2014 Apr 29;(4):CD006134.Texto completo Resumen
Artículos de referencia
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Diferenciales
- Ovarian cancer
- Ovarian torsion
- Polycystic ovary syndrome
Más DiferencialesGuidelines
- ACR appropriateness criteria® clinically suspected adnexal mass, no acute symptoms
- Initial investigation and management of benign ovarian masses
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