Post Menopausal Simple Ovarian Cysts
These are for simple cysts or cysts with one thin septation (<3mm). These are anechoic, with smooth thin walls, posterior acoustic enhancement, no solid component and no internal flow at colour Doppler ultrasound.
Transabdominal and transvaginal scans are recommended.
- Simple cysts < 3 cm need no follow up
- One thin septation (<3mm) or small calcification in wall is almost always benign. Treat as simple and follow up according to size of cyst.
- Cysts >5cm recommend urgent referral to gynae 2WW clinic with CA125
- Complex ovarian cysts of any size recommend urgent referral to gynae 2WW clinic with CA125. Use colour Doppler to assess solid elements / papillary projections.
- Symptomatic cysts of any size may need referral to the General Gynae Clinic
- Always review previous imaging US/CT/MRI if available- if unchanged over one year then no need to follow up.
- Ask GP to check CA125 and arrange F.U. as above.
- Levine D et al. Management of Asymptomatic Ovarian and other Adnexal Cysts Imaged at US: Society of Radiologist in Ultrasound Consensus Conference Statement. Radiology 2010;256:943-954
- Sauders B et al. Risk of malignancy in sonographically confirmed septated cystic ovarian tumors. Gynecologic Oncology 2010;118:278-282
- Greenlee R et al. Prevalence, incidence, and natural history of simple ovarian cysts among women >55yrs old in a large cancer screen trial. American Journal of Obstetrics and Gynecology. 2010;202:373.e1-9
- Ovarian Cysts in Postmenopausal women. Royal College of Obstetricians and Gynecologists 2003 Guideline No 34.