Management of a simple ovarian cyst

What it is

Ovarian cysts divide into a non-neoplastic group of benign functional cysts and a neoplastic group. The functional cysts are the follicular cyst, the luteal cyst of the corpus luteum, and the theca lutein cyst, the pregnancy luteoma; the neoplastic group holds endometriomas together with benign and malignant tumours.

Complexity is what the word simple refers to. A cyst is simple when it is under 10 cm with clear serous fluid and a smooth internal lining, and complex when it is over 10 cm with heterogenous fluid and an irregular border.

A follicular cyst is seen in PCOS. A luteal cyst arises when the corpus luteum fails to regress after 14 days; it is more painful and can turn into hemorrhagic if the ovarian vessels invade the cyst. A theca lutein cyst is seen in molar pregnancy, is usually bilateral, and regresses after delivery. In a child, a unilocular small ovarian cyst is a benign functional cyst, whereas a solid mass points to a germ cell tumour.