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Adnexal Cyst Follow-Up

An adnexal cyst is a fluid-containing lump in the area of the pelvis around the uterus. This includes the ovaries, fallopian tubes, and surrounding tissues. Simple ovarian cysts frequently form during the normal menstrual cycle and are not considered to be a problem. In addition, ovarian cysts will form in approximately 20% of postmenopausal women.

Adnexal cysts can be categorized as simple or complex depending on their characteristics seen on the ultrasound. Most women with simple adnexal cysts do not need additional imaging tests after an initial transvaginal ultrasound. Ovarian cancer is unlikely to arise from these benign-appearing cysts. However, women experiencing severe pain or worsening symptoms should be re-evaluated.

In women of reproductive age, simple cysts larger than 5 cm may require some form of additional imaging and annual ultrasound imaging follow-up. In postmenopausal women, follow-up is recommended for simple cysts larger than 1 cm in greatest diameter. Additional imaging is also indicated for complex adnexal masses having both fluid and solid parts on ultrasound in both pre- and postmenopausal women. Depending on the size and location of the cyst, transabdominal ultrasound may be used in addition to transvaginal ultrasound for initial evaluation. Color Doppler ultrasound imaging is used to evaluate the solid parts of a complex cyst and to look for blood vessel characteristics that may suggest a cancer is present.

An MRI or a CT scan is recommended when the ultrasound test does not provide enough information to tell whether cancer might be present.

This page was reviewed on December, 15, 2021

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