DIAGNOSIS AND FOLLOW-UP OF SIMPLE OVARIAN CYSTS DETECTED BY ULTRASOUND IN POSTMENOPAUSAL WOMEN

Objective: To determine the malignancy rate in ultrasound-diagnosed, a nechoic, small, simple ovarian cysts in postmenopausal women, and to i nvestigate the natural history of these cysts by ultrasound follow-up. Methods: Eighty-three postmenopausal women with small, completely ane choic, thin-walled ovarian cysts (less than 5 cm, mean of orthogonal d iameters) were diagnosed at our ultrasound unit during the period 1983 -1992. Forty-three underwent surgery; the remaining 40 were offered fo llow-up ultrasonography as part of the present study, and, of them, fi ve died, two were unavailable because of intercurrent disease, and one moved abroad, leaving 32 to be included in our study. Results: There were no cases of ovarian cancer in the surgery group. In the nonsurger y (follow-up) group, the time since detection of the lesion ranged fro m 1-9 years. On follow-up ultrasonography, 12 of the 32 cysts had disa ppeared and only one had increased in size. According to histopatholog y records, no ovarian cancer was diagnosed in any of the seven cases i n which the patient was not available for reexamination by ultrasound. Conclusion: Nonpalpable ovarian cysts are commonly detected by ultras ound in asymptomatic women, but the risk of malignancy appears to be v ery low. We recommend ultrasound follow-up of stationary lesions and t hat surgery be confined to symptomatic cases or those in which there i s a family history of ovarian, breast, or colon cancer.