studies have estimated the incidence is between 5% and 17%.
premenopausal ( 90%- benign)
- Postmenopausal- 60% benign
- 10% of women will have some form of surgery during their lifetime for the presence of an ovarian mass
- 10% of suspected ovarian masses are non-ovarian in origin
- Incidence of a cyst being malignant in pre-menopausal is 1:1000
- It increases to 3:1000 at age of 50 yr
Usual presentation one of three ways
○ Acute pain (e.g. torsion or rupture of a cyst)
○ Ovarian cysts identified during gynaecological investigations – Ex: PMB
○ Incidentally
20% of borderline tumors appear as simple cysts in USS
- To be classified as an ovarian cyst size must be >1cm
- features of simple cyst
- On transvaginal ultrasound,
- 1.round or oval shape
- 2.thin or imperceptible wall
- 3.posterior acoustic enhancement
- 4.anechoic fluid, and
- 5.absence of septations or nodules
- An ovarian cyst is defined as complex in the presence of one or more features:
- ● complete septation (i.e. multilocular cyst)
- ● solid nodules
- ● papillary projections
- CA125
- i. Not routinely used
- ii. Poor specificity
- iii. Increased false positivity
- iv. Increased 100 -1000 even in grade 3 endometriosis
- v. Marker of EOC ( increased only in 50%)
- vi. Lower CA125 with caffein, smoking, hysterectomy
- women could be counselled that RMI scores of less than 25 -less than 3%
- between 25 and 250 -20%
- and greater than 250 carry a risk of cancer 75%
| sensitivity% | specificity% | |
| RMI 1 200 250 | 78 70 | 87 90 |
| IOTA | 95 | 91 |
| ROMA menopausal,CA125,HEA No uss |
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