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
Management of ovarian cysts depends on age, hormonal status and sonographic features
The physician’s role in the approach to ovarian masses is largely to exclude cancer
Ovarian cysts in prepubertal patients especially after the first weeks of life are abnormal and likely to be neoplastic, prompt ultrasound evaluation and referral are warranted
In adolescent patients, majority of ovarian masses are functional cysts
The most common neoplastic ovarian tumor in this age group is benign cystic teratoma of the ovary
Ovarian mass in women of reproductive age is mostly benign but the risk of malignancy increases with age
In most adnexal masses, malignancy is found in 7-13% of premenopausal patients and 8-45% of postmenopausal patients
Risk of malignancy for ovarian tumor in patients <45 years old is <1 in 15 while in postmenopausal women, the figure is 50% at the time of laparotomy
Risk of malignancy is low (<1%) for simple ovarian cystic masses <10 cm in diameter
Complications include cyst rupture and torsion
Consider ovarian cyst rupture, torsion, or hemorrhage in postmenopausal women with acute abdominal pain
Signs and Symptoms
Often asymptomatic, most ovarian masses manifest with few or mild nonspecific symptoms
Common symptoms associated with ovarian cancer include abdominal distension, abdominal pain or discomfort, metrorrhagia, dyspareunia, infertility, lower abdominal pressure sensation and urinary or gastrointestinal symptoms
