Ovarian cysts are found in 7.8% of asymptomatic fertile aged women

Ovarian cysts are found in 7.8% of asymptomatic fertile aged women. Post-menopausal women exhibit a prevalence of 2.5 to 18%. An ovarian cyst is detected either as an incidental finding, in ultrasonography performed for lower abdominal pain, or on the basis of a suspicious finding in pelvic examination. With easy availability of ultrasonography asymptomatic ovarian cysts are detected in an increasing number. Most cysts are benign and often vanish spontaneously. Therefore in the absence of suspected malignancy or harmful symptoms, it is unnecessary to expose the woman to the risks of the operation.

Incidental adnexal masses occur with relatively high frequency in post-menopausal women, with a prevalence rate of 3.3-18% in asymptomatic patients. Unilocular, benign-appearing ovarian cysts represent the vast majority of abnormal findings at transvaginal ultrasonography. As many as 80% will resolve over a period of several months; if persistent, unchanged, less than 10 cm, and with normal CA-125 values, the likelihood of an invasive cancer is sufficiently low that observation should be offered. More recent investigations support the use of secondary imaging modalities such as MRI, which may help differentiate benign from malignant masses. Surgical management plays a key role when patients are symptomatic regardless of age, menopausal and have documented changes in cyst characteristics, experience elevations in tumor markers or have symptoms suggestive of a hormone-producing neoplasm. High level, evidence-based screening guidelines have yet to be developed.

From PMID