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Ovarian cysts: a clinical dilemma
1Department of Obstetrics and Gynecology, Hadassah Medical Center, Hebrew University Medical School, Jerusalem, Israel.
Summary
Ovarian cysts are frequently detected using ultrasound across all ages. While many resolve spontaneously or with treatment, suspicious signs like large size or increased blood flow may indicate malignancy, requiring prompt medical intervention.
Area of Science:
- Gynecology
- Radiology
- Oncology
Background:
- Ultrasound technology advancements have increased ovarian cyst detection.
- Ovarian cysts can occur at any life stage, from fetal to postmenopausal.
Purpose of the Study:
- To review the detection, diagnosis, and management of ovarian cysts.
- To highlight ultrasound's role in differentiating benign from malignant cysts.
Main Methods:
- Transvaginal sonography for detection and diagnosis.
- Color Doppler studies and CA-125 levels for malignancy assessment.
- Clinical evaluation for management decisions.
Main Results:
- Most functional cysts in fertile women resolve spontaneously or with oral contraceptives.
- Symptomatic fetal cysts may require surgery; expectant management is common.
- Signs of neoplasia include large size, multiloculation, septa, papillae, and increased blood flow.
- Ovarian cancer incidence rises with age, primarily affecting peri- and postmenopausal women.
Conclusions:
- Ultrasound is crucial for ovarian cyst diagnosis and malignancy suspicion.
- Prompt surgical exploration is indicated for suspected malignant cysts.
- Management strategies vary based on cyst characteristics, patient age, and symptoms.