Ovarian cyst - Wikipedia, the free encyclopedia - 0 views
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Most ovarian cysts are functional in nature and harmless (benign).[1][2] Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years. Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
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Functional cysts form as a normal part of the menstrual cycle. Such cysts may include: Follicular cyst, the most common type of ovarian cyst. In menstruation, a follicle containing the ovum (unfertilized egg) will rupture during ovulation. If this does not occur, a follicular cyst of more than 2.5 cm diameter may result.[3] Corpus luteum cysts appear after ovulation. The corpus luteum is the remnant of the follicle after the ovum has moved to the fallopian tubes. This normally degrades within 5–9 days. A corpus lutem that is more than 3 cm is defined as cystic.[3] Thecal cysts occur within the thecal layer of cells surrounding developing oocytes. Under the influence of excessive hCG, thecal cells may proliferate and become cystic. This is usually on both ovaries.[3]
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Non-functional cysts may include: An ovary with many cysts, which may be found in normal women, or within the setting of polycystic ovary syndrome. Cysts caused by endometriosis, known as chocolate cysts. Hemorrhagic ovarian cyst Dermoid cyst Ovarian serous cystadenoma Ovarian mucinous cystadenoma Paraovarian cyst Cystic adenofibroma Borderline tumoral cysts
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There are several systems for scoring of the risk of an ovarian cyst of being an ovarian cancer, including RMI (risk of malignancy index), LR2 and SR (simple rules). Sensitivities and specificities of these systems are given in tables below:[5] Scoring systems Premenopausal Postmenopausal Sensitivity Specificity Sensitivity Specificity RMI I 44% 95% 79% 90% LR2 85% 91% 94% 70% SR 93% 83% 93% 76% Risk of malignancy index[edit] A widely recognized method of estimating the risk of malignant ovarian cancer based on initial workup is the risk of malignancy index (RMI).[6] It is recommended that women with an RMI score over 200 should be referred to a center with experience in ovarian cancer surgery.[7] The RMI is calculated as follows:[7]