Welcome to your Ovarian Cysts In Postmenopausal Women

1. Ms. X, 54 years old postmenopausal woman has been referred by GP as she has vague symptoms of abdominal discomfort & bloating sensation. On examination Abdomen -soft, bimanual pelvic examination -uterus -atrophic, ovaries -not palpable. Trans vaginal ultrasound scan - right ovarian cyst -simple unilocular cyst measuring, 4cm. No solid lesions noted, no ascites noted. Ca-125-30 IU /ml. What is the best possible management?

2. Ms. X, 54 years old postmenopausal woman has incidental finding on ultrasound scan - right ovarian cyst - Multi locular cyst measuring, 4cm. No solid lesions noted, mild ascites noted. Her CA-125-32 IU /ml. What is her RMI score?

3. CA-125 is tumour marker for Serous epithelial ovarian cancer. In what percentage of early stage disease, CA-125 is raised?

4. Postmenopausal lady presents with abdominal distension, early satiety, blasting sensation, loss of weight as well as vague pelvic pain. These symptoms are suspicious of ovarian cancer if they are persistent and frequent.
What’s the frequency to tell them that these symptoms are frequent?

5. All are true regarding CA-125 except

6. Ms. X, 44 years old, chronic smoker complains of shortness of breath. On examination, respiratory rate is 26, spo2-85%, abdomen examination shows mass corresponding to 14weeks gestation. Pelvic ultrasound shows unilateral mass -solid mass with ascites. CA-125is 60mIu/m. X Ray shows pleural effusion. What is the probable diagnosis?

7. A 60. year-old postmenopausal woman presents with pelvic pain and a persistent 6.5 cm simple unilocular ovarian cyst on ultrasound. Her CA-125 is 26 IU/mL. She chooses for surgical management.

8. It is recommended that ‘risk of malignancy index’ (RMI) should be used to triage post-menopausal women with an ovarian cyst to assess low, moderate or high risk of malignancy. This is calculated as U (ultrasound score) X M (menopausal status) X CA125.

What is the RMI of a post-menopausal woman with a CA125 of 15, ultrasound showing 6 cm bilateral, multiloculated cyst?

9. Post menopausal women with simple cyst CA-125, RMI low risk. Management plan

10. When evaluating the Ovarian cysts , Calculation of the Risk of Malignancy Index (RMI) is based on the following items EXCEPT :