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.
• 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.

 

References

• 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.
• https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg_34.pdf

 

 

Date Reviewed                                 March 2021

Date Next Review                             March 2022

Author:                                              Dr Sheona Burns RMS GP Lead Gynacology

Contributor                                        Dr Lisa Verity, Consultant Royal Cornwall Hospitals Trust

 

Version No.        2.0