THE CASE AGAINST ASPIRATING OVARIAN CYSTS

Background. Developments in ultrasonographic technology have increased the possibilities of ovarian cyst aspiration. The risk of an extensio n of indications for ovarian cyst aspiration, however, is iatrogenic s pread of malignant cells. Methods. In this article, the diagnostic acc uracy and therapeutic effectiveness of ovarian cyst aspiration are dis cussed, and the potential risk from different forms of tumor spill are considered. Results. Two cases are presented in which a laparoscopic puncture and aspiration of a malignant ovarian cyst were performed. In both cases, there were diagnostic problems with the cytologic assessm ent. In one case, aspiration of an apparently benign cyst, based on ul trasonographic and laparoscopic findings, yielded cytologically negati ve fluid, but 8 weeks later an extensively disseminated ovarian carcin oma was found at laparotomy. It is postulated that the time interval b etween first tumor spill and eventual removal of the diseased ovary is the most important determinant of prognosis. Conclusions. The conclus ion of these case reports is that aspiration of ovarian cysts, except for the purposes of oocyte retrieval, is potentially dangerous and sho uld not be regarded as routinely acceptable clinical practice.