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Pathway Guide – Ovarian Cyst Management Pathway Guide – Ovarian cysts: General Information| Saint Mary’s Lead: Dr Ursula Winters & Dr Rohit Arora | v1.0 | Created: 03/02/21 Knowing the options
When a scan report is received indicating an ovarian cyst, there are only three options for further management which are to repeat, to reassure, or to refer (either routine or urgent). Most scan reports will include management advice based on the following pathways. When reviewing a scan result, patients should be managed according to their fertility status: Pregnant, Pre-menopausal, and Post-menopausal.
Ultrasound features can be broadly divided into benign (reassuring) or malignant (suspicious) as shown in the table below:<br>
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Pathway Guide – Ovarian cysts: Pre-menopausal Pathway Guide – Ovarian cysts: Pre-menopausal| Saint Mary’s Leads: Dr Ursula Winters and Dr Richard Clayton | v1.0 | Created: 03/02/21 National Guidance
RCOG Patient Information
NHS Website Referral Proforma
2WW where appropriate Endometrioma/ dermoid cyst Suspicious features Complex cyst >7cm >5cm Request Ca 125 + Refer Suspected Gynaecological Cancer <5cm likely functional Simple cyst: Reassure 5-7cm Repeat scan at 3 months Refer to Gynaecology <5cm Repeat scan at 3 months Persistent and 3-5cm Resolved Reassure 2-week Suspected Cancer referral criteria: REFER SUSPECTED GYNAECOLOGICAL CANCER
-Abnormal abdominal/pelvic ultrasound suggestive of ovarian cancer CA125 <35 CA125 >35 Refer to Gynaecology<br>
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Pathway Guide – Ovarian cysts: Post-menopausal Pathway Guide – Ovarian cysts: Post-menopausal| Saint Mary’s Leads: Dr Ursula Winters and Dr Richard Clayton | v1.0 | Created: 03/02/21 National Guidance
RCOG Patient Information
NHS Website Referral Proforma
2WW where appropriate Ca125 <35 Repeat USS in 4 months Complex, multi-locular, separate solid component. Do Ca125 Ca125 >35 Ca125 >35 Refer via 2-week wait cancer pathway <5cm Simple, unilocular, no solid components <5cm >5cm Ca125 <35 Refer to Gynaecology Reassure >5cm<br>
