Hi, been very busy in RL and so haven’t been around much, but got the message from @JLeslie .
Ovarian cysts are almost always benign. The term “cyst means a pocket of fluid think water balloon. A simple cyst less than 3cm in diameter doesn’t even need follow up. We do repeat ultrasound to follow simple cysts > 3cm or “complex” cysts. A complex cyst is one that is septated, meaning it has partitions like a pair of cysts right next to each other or if it has floating debris inside usually hemorrhagic from some blood.
Most of the time, cysts are “functional”, meaning part of the monthly process of ovulation. So we generally get a repeat ultrasound in about 6 weeks. If the cyst is big enough to cause pain, we might put the woman on COCs combination oral contraceptives until the next look, to help the cyst resolve. Sometimes I’ll also get a CA-125 for extra reassurance that it’s OK to observe until the next ultrasound.
Most of the time, the cyst has resolved by the next ultrasound. If it hasn’t, then there’s a consultation with a gynecologic surgeon to talk about laparoscopy to remove the cyst. Even then, the cysts are usually benign.
If the cyst/mass looks worrisome for malignancy, then we get a CA-125 and think about removal for biopsy sooner. A worrisome mass would have a combination of fluid and solid along with other features that don’t look benign.