Top Form Tuesday: Ultrasound to Determine if a Pelvic Mass is Persistent.

Dermoid Cyst of the Ovary (Benign Cystic Teratoma)
Most ovarian cysts come and go. In fact most ovarian cysts never make it to the attention of your health care provider. However, those ovarian cysts that are present on a serial set of ultrasounds become signficantly less likely to ever resolve without your gynecologist intervening. Persistent pelvic masses are not always ovarian cancers, in fact many will be the non-cancerous dermoid cyst shown in this picture.In a review of a study of ovarian masses seen on ultrasound in women over 50 a new study reported in the AJOG in November 2015 has shown that watching and repeating the ultrasound actually did better at determining if an ovarian mass was really cancerous. In this study patients were watched over 3 years. In the past it was thought that a mass of stable size over 6 months would not be a cancer. The theory was that ovarian masses either are cancerous or not cancerous and that masses that are not cancerous cannot evolve into a cancer. This has now been challenged and there is a group of experts that think ovarian masses will go through a progression from non-cancer to borderline tumors, and eventually turn invasive if not removed.  Each patient is encouraged to speak to her own gyno if she has a suspected ovarian tumor so that she can get advice.

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