Figure 2 For Mgt Of Benign Ovarian Tumours

Figure 2:

A flow chat illustrating the management of small asymptomatic cyst in post menopausal women Asymptomatic ovarian cyst < 10cm in post menopausal women

cyst disappeared

repeat USS in 3 months

Reassure Colour Doppler Studies

Persists but Simple

Serum CA 125 Levels determination

Persists and enlarging

Persists with additional USS features e g solid areas Papillary projections, septa, Ascites

TAH, BSO,

Normal CA 125 (< 35 IU/ML)

Elevated CA 125 (> 35 IU/ML)

Manage individually*

TAH, BSO,

Normal Doppler indices

Manage individually *

Abnormal Doppler indices

TAH, BSO

TAH, BSO, Omentectomy

* for e g elderly patients with multiple medical problems would best be managed conservatively while healthy women who are anxious because of a family history of ovarian or breast cancer or BRCA gene mutations can best be managed by surgical removal.