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. 2020 Oct;45(10):3213-3217.
doi: 10.1007/s00261-019-02176-z.

Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm

Priyanka Jha  1 , Mallika Shekhar  2 , Ruth Goldstein  2 , Tara Morgan  2 , Liina Poder  2
Affiliations

Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm

Priyanka Jha et al. Abdom Radiol (NY). 2020 Oct.

Abstract

Objectives: To assess 3 cm size threshold for follow-up of simple cysts in postmenopausal women.

Materials and methods: Radiology information system was retrospectively queried for "US pelvis complete" over 8 years in women > 50 years, with keywords ovarian cyst, adnexal cyst, ovarian mass, cystic mass, cystic neoplasm, ovarian neoplasm, and ovarian mass. Premenopausal women were excluded. Cysts, were classified as ≤ 1 cm, 1-3 cm, 3-5 cm, and ≥ 7 cm. Largest cysts on each ovary was recorded. EMR and imaging archives were reviewed for assessing size, stability duration, and surgical records. Descriptive statistics and confidence interval were performed.

Results: 4388 patients met the initial search criteria. 919 cysts in 896 women (age: 50-91 years, mean: 61.5 years) were identified. We found 162 cysts ≤ 1 cm, 352 1-3 cm, 296 3-7 cm , and 51 ≥ 7 cm cysts. 127 patients with 1-3 cm cysts had no follow-up. Final analysis of 225 1-3 cm cysts included 203 ovarian and 22 paraovarian cysts (average size = 1.95 cm (1.1-3.0 cm)). 103 ovarian cysts had less than 2 years, and 100 cysts had more than 2 years follow-up. All except one ovarian cyst were stable for the entire duration of their follow-up (Mean duration of follow-up 5.4 years) (0.3%, 95% CI 0.0-0.05). 40 cysts resolved. One simple cyst increased in size (followed over 3.25 years) without suspicious imaging features and benign on surgery.

Conclusion: 1-3 cm cysts represented the most common size range (> 40%) in postmenopausal women, majority of which are stable over follow-up with benign outcome. 3 cm size threshold is appropriate for simple cyst follow-up in postmenopausal women.

Keywords: Adnexal cyst; Follow-up; MRI; Ovarian cyst; Simple cyst; Size threshold; US; Ultrasound.

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