Pre-menopausal ovarian cysts

Who to refer:

The radiology department will include in their report whether M features are present and will indicate if referral to gynaecology on an urgent or routine basis is required. Please refer to gynaecology in line with this recommendation

The report will also indicate if a follow up scan is required.

If women are amenorrheic due to hormonal medication, hysterectomy or endomtrial ablation, women under 50 should be regarded as premenopausal.

Who not to refer:

This guideline relates to women in whom ovarian pathology has been identified on USS.  It does not relate to women presenting with acute symptoms in which a diagnosis of an ovarian cyst accident is suspected.  In such cases, patients should be discussed with the on-call gynaecology doctor via switchboard.

How to refer:

Via SCI gateway

Do not check Ca125 during menstruation as this can lead to false positive results.

Ca 125 can be increased by fibroids or endometriosis.

Follow up ultrasound scans, where indicated within the flowchart, should be requested upon receipt of the index scan report.

• RCOG Green-top Guideline No. 62.  Management of Suspected Ovarian Masses in Premenopausal Women https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg62/
• RCOG Green-top Guideline No. 34 Ovarian Cysts in Postmenopausal Women https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg34/