A 30 years old multiparous woman is found to have a 5 -- 6 cm cyst in one ovary. The most appropriate line of management would be :
Ans. is d i.e. Observation to see if it disappears by itself within three months Most follicular cysts disappear spontaneously within a few weeks to months. If any cyst persists for longer than 2 months, the possibility of neoplastic cyst must be kept in mind and patient should be investigated. "In premenopausal patient, a period of observation is reasonable, provided mass is not clinically suspicious (that is mobile, cystic, unilateral and of regular contour). Generally an interval of 2 months is allowed for observation. The size of the lesion is of impoance. If a complex cystic mass .> 8 -- 10 cm in diameter, the probability of lesion being neoplastic is high." Patients whose lesions are suggestive of malignancy (i.e. predominatly solid, relatively fixed or irregularly shaped) should undergo laparotomy, as should postmenopausal patients with complex adnexal masses of any size. In postmenopausal women with unilocular cysts measuring 8 to 10 cms or less and having normal serial CA 125 levels, expectant management is acceptable.
Laparotomy as cystectomy
Laparotomy and unilateral salpingo-oophorectomy
Laparoscopic aspiration of the cyst
Observation to see if it disappears by itself in three months