USS features
*Can be divided into those demonstrating benign (reassuring) features or malignant (suspicious features). IOTA group rules for classification of ovarian masses.
| Benign/More reassuring Features (Simple) | Malignant/Suspicious Features |
| Unilocular cysts | Multilocular cysts |
| Diameter <10cm | Diameter >10cm |
| Minimal solid component <7mm | Solid component >7mm |
| Smooth outline | Irregular outline |
| Acoustic Shadowing indicating dermoid | Features not indicative of dermoid |
| No blood flow | Prominent blood flow on Doppler |
| No/Little fluid | Ascites |
Who to refer:
Women with ovarian pathology identified on USS arranged via primary care (see flow chart).
Who not to refer:
This guideline relates to women in whom ovarian pathology has been identified on USS. It does not relate to women presenting with acute symptoms in which a diagnosis of an ovarian cyst accident is suspected. In such cases, patients should be discussed with the on-call gynaecologist
How to refer:
Sci-Gateway > RIE > Gynaecology > Ovarian Pathology
Measure CA125 (not during menstruation) for women with complex cystic/solid tumour suspicious for malignancy
RCOG Green-top Guideline No. 62. Ovarian Masses in Premenopausal Women, Management of Suspected
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg62/
RCOG Green-top Guideline No. 34 Ovarian Cysts in Postmenopausal Women https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg34/
