Postmenopausal largish cyst on one ovary - what normally happens next?

[Aquinnah]

Over a year ago,when I was sent to a for ultrasound due to p/m bleeding, they discovered a cyst on each ovary. It caused a lot of excitement (and me a lot of anxiety) as one was septated and I was sent for Ca125 + CAT Scan. The Ca125 was fine and at the second u/s my septated cyst had disappeared. The other one has stubbornly remained however, and at the last check in April, 11 months after the first u/s, it had also grown slightly, now to 5.7cm (previously it was just under 5cm). It is still simple and has no worrying features, however, and so I will be checked yet again in October + another appointment.I have read the UK Royal College of Obstetricians and Gynaecologists Green topped Guidelines (2003) which very clearly lays out a protocol for how to manage pm cysts, but it gets a little less clear with just over 5cm ones that look otherwise perfectly OK. I suspect, particlurly if it grows a little more, that they will want to remove it, + poss my ovaries aw well. Has anyone got any experience of this?  (Later last summer I also had a hysteroscoscpy as I had further bleeds, but all was well, and since then I have had no further bleeds).

[Machelle Seibel, MD]

A. It is very good that you have had a normal CA 125 and the CAT Scan has shown one cyst resolved and the other appears to be a simple cyst.  In most situations, if a cyst continues to grow after menopause and it is now bigger than 5 cm, the doctor will want to be sure that the cyst is not a tumor.  Sometimes an ultrasound can be done that uses Doppler. That is a method which measures the blood pressure and blood flow in the blood vessels that lead to the cyst.  That can sometimes help reassure the doctor that the cyst is benign.  However, they might want to do a laparoscopy which is an operation done in the operating room using anesthesia and a thin telescope to look into the abdomen and either sample the cyst or remove it.  After menopause, the doctor might want to remove the ovary as well.
Machelle M. Seibel, MD

[Aquinnah]

Thanks. Your answers tallies with what I am expecting. With luck this cyst may have disappeared by October!