For an ovarian cyst smaller than 8 cm in a premenopausal patient, which management is recommended?

For an ovarian cyst smaller than 8 cm in a premenopausal patient, which management is recommended?

• A. Supportive management; most are functional and resolve spontaneously
• B. Immediate surgery
• C. Chemotherapy
• D. No monitoring needed; refer to gynecology annually

Answer: (A)

Functional ovarian cysts are a common finding in premenopausal women and typically arise from normal ovulatory cycles. They are usually benign and self-limited, often shrinking and resolving within one to two menstrual cycles. When a cyst is under about 8 cm and there are no concerning features on ultrasound (no solid components, thick walls, papillary projections, or complex characteristics) and the patient is asymptomatic, the best approach is watchful waiting with reassurance. The usual plan is to obtain follow-up imaging in 6–8 weeks to confirm that the cyst has resolved; if it does, no further workup is needed. If the cyst persists, enlarges, recurs, or develops suspicious features, then gynecologic evaluation and possible surgical management are considered. Immediate surgery, chemotherapy, or no monitoring are not appropriate in this scenario because the likelihood of malignancy is low and most small functional cysts resolve spontaneously.

Functional ovarian cysts are a common finding in premenopausal women and typically arise from normal ovulatory cycles. They are usually benign and self-limited, often shrinking and resolving within one to two menstrual cycles. When a cyst is under about 8 cm and there are no concerning features on ultrasound (no solid components, thick walls, papillary projections, or complex characteristics) and the patient is asymptomatic, the best approach is watchful waiting with reassurance. The usual plan is to obtain follow-up imaging in 6–8 weeks to confirm that the cyst has resolved; if it does, no further workup is needed. If the cyst persists, enlarges, recurs, or develops suspicious features, then gynecologic evaluation and possible surgical management are considered. Immediate surgery, chemotherapy, or no monitoring are not appropriate in this scenario because the likelihood of malignancy is low and most small functional cysts resolve spontaneously.