Ovarian cysts

Last reviewed: 9 Nov 2022
Last updated: 24 Sep 2021

Summary

Definition

History and exam

Other diagnostic factors

  • pelvic pain
  • bloating and early satiety
  • palpable adnexal mass
Other diagnostic factors

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
More risk factors

Diagnostic investigations

1st investigations to order

  • transvaginal ultrasonography
More 1st investigations to order

Investigations 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
More investigations to consider

Emerging tests

  • PET imaging of abdomen/pelvis
  • serum biomarkers (ovarian adnexal mass assessment score test system)

Treatment algorithm

ACUTE

acutely ill

ONGOING

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

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.

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