Risk of malignancy of small unilateral ovarian cysts in postmenopausal women and the importance of surgical treatment

A small asymptomatic one-sided ovarian cyst in postmenopausal women is a frequent occurrence. The management of these lesions depends on the severity of clinical signs and the risk of malignancy. Most ovarian cysts are benign and regress themselves. However, the risk of a neoplastic process always persists; therefore, surgical treatment of such cysts is applied. The aim of this literature review is to determine the frequency of malignancy of a small (?5 cm) asymptomatic one-sided ovarian cyst in postmenopausal women and the best method of its management. To conclude, the risk of malignancy of small asymptomatic one-sided ovarian cysts in postmenopausal women is low. In evaluating the risk of malignancy, important are the risk of the malignancy index, which takes into account the ultrasound features of the ovarian cyst, the CA125 value and the patients age. It is important not to overestimate the need of surgical treatment. Careful consideration of the patient’s medical and family history as well as careful counselling res crucial. In the presence of an increased CA125 value and/or new features at the repeated ultrasound examination, surgery should be considered