A 61 years old post-menopausal woman with a family history of ovarian cancer presents with pain abdomen. She is on hormone replacement therapy. An abdominal ultrasound revealed a smooth cyst in the right ovary. What should be done next?
(A) Observe and reassure the patient (B) Laparoscopic surgery to visualize the nature of the cyst (C) Drilling of cysts (D) Check CA-125 levels and advise regular follow-up if normal
(D) Answer-D. Check CA-125 levels and advise regular follow-up if normalThis is a post-menopausal patient with a simple (smooth) qtst in the ovary. Such a cyst doesn't needfuher investigations,but this patient has two risk factors for malignancy: Family history of ovarian tamor and history of Hormonal therapy.Hence, CA-125 levels should be evaluated and the RMI-I score (Risk of Malignancy index) calcalated before proceedingfor regular follow up. If RMI score exceeds 200,fuher imaging laparoscopic surgery will be needed in this patient.