Summary
Definition
O cisto ovariano é o achado cirúrgico, de imagem ou clínico de um ovário aumentado e preenchido por fluido ou de porção de tecido ovariano preenchida por fluido. Os cistos ovarianos implicam um processo fisiopatológico que envolve o próprio ovário.[Figure caption and citation for the preceding image starts]: Vista laparoscópica de um cisto ovariano in vivoDo acervo do Professor Michael Hopkins [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
Other diagnostic factors
- dor pélvica
- distensão abdominal e saciedade precoce
- massa anexial palpável
Risk factors
- faixa etária pré-menopáusica
- menarca precoce
- primeiro trimestre da gestação
- história pessoal de infertilidade ou síndrome do ovário policístico
- gonadotrofinas intrínsecas ou extrínsecas elevadas
- terapia com tamoxifeno
- tabagismo
- história pessoal ou familiar de endometriose
Diagnostic investigations
1st investigations to order
- ultrassonografia transvaginal
Investigations to consider
- antígeno de câncer (CA)-125 sérico
- ultrassonografia do abdome/pelve com power Doppler colorido
- ressonância nuclear magnética (RNM) de abdome/pelve
- tomografia computadorizada (TC) de abdome/pelve
- análise de cariótipo
- laparoscopia/laparotomia e histopatologia
Emerging tests
- tomografia por emissão de pósitrons (PET) de abdome/pelve
- biomarcadores séricos (sistema de teste de escore de avaliação de massa anexial ovariana)
Treatment algorithm
agudamente doente
não gestante: pré-menopausa com cisto ovariano simples
não gestante: pré-menopausa com cisto ovariano complexo
não gestante: pré-menopausa com cisto ovariano sólido
menopausada: com cisto ovariano simples
menopausada: com cisto ovariano complexo
menopausada com cisto ovariano sólido
gestante
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.
References
Key articles
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. Abstract
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. Abstract
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].Full text
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. Abstract
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):359-371.Full text Abstract
Grimes DA, Jones LB, Lopez LM, et al. Oral contraceptives for functional ovarian cysts. Cochrane Database Syst Rev. 2014 Apr 29;(4):CD006134.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Câncer de ovário
- Torção ovariana
- Síndrome do ovário policístico
More DifferentialsGuidelines
- Ovarian cancer: recognition and initial management
- ACR appropriateness criteria® clinically suspected adnexal mass, no acute symptoms
More GuidelinesPatient information
Cisto ovariano
Câncer de ovário
More Patient information
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