Abstract
Objective
To evaluate the malignancy potential of large unilocular and multilocular ovarian
cysts in postmenopausal women and to discuss their appropriate management.
Study design
This retrospective study included 204 postmenopausal patients who underwent surgery
for simple adnexal cysts or cysts with isolated septal structures at the Gynecology
and Obstetrics Clinic of Bakirkoy Dr Sadi Konuk Training and Research Hospital. Data
obtained from patient and computer records included patient age, follow-up period,
ultrasonography reports, surgery information, histopathological evaluation results,
and cancer antigen-125 (CA-125) levels at diagnosis and during follow-up. The Kruskal–Wallis
test was used to compare three or more groups. The Chi-square test or Fisher's exact
test was used to compare qualitative parameters, while relationships between parameters
were analyzed by using Spearman's correlation analysis.
Results
A total of 236 cysts were identified in 204 postmenopausal women who underwent surgery.
The cysts were categorized as having unilocular cyst morphology or complex structures
without morphological abnormalities other than septa in 182 (77.1%) and 54 cases (22.9%),
respectively. The mean cyst diameter was 6.6 ± 3.1 cm (range, 2.7–30 cm) with diameters ≥5 cm in 176 cysts (75%). The median cyst volume was 88.5 cm3 (range, 10–2636; interquartile range: 81) and the mean morphology index was 1.2 (range,
1–6), with 16 cysts (6.8%) ≥5. No malignancy or borderline histology was observed
in any patient.
Conclusions
Among postmenopausal women, cysts that are unilocular or contain isolated septa, have
a low-risk of malignancy even when they are larger than 5 cm. Rather than undergoing emergency surgery, these patients may be followed up conservatively
with intermittent transvaginal ultrasonography.
Keywords
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Article info
Publication history
Published online: May 20, 2016
Accepted:
May 13,
2016
Received in revised form:
April 25,
2016
Received:
February 19,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
