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The incidental postmenopausal adnexal mass
J Matt McDonald1, Susan C Modesitt
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0298, USA.
Abstract:
The postmenopausal ovary continues to produce cysts; the prevalence in an ovarian cancer screening population approaches 18%. Yet 60% to 70% of unilocular cysts resolve spontaneously. Optimal management of an asymptomatic adnexal mass allows surveillance of women at low malignancy risk while triaging intermediate/high-risk women to surgery. Women with unilocular cysts on transvaginal ultrasound (TVS) and a normal CA-125 are monitored with repeat TVS at 3 to 6 months. Those with a complex mass <5 cm and normal CA-125 should have repeat TVS and CA-125 testing in 4 weeks. Surgery is recommended for any women with increasing morphologic complexity or a rising CA-125.
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