This guidance applies to incidental findings on CT or MRI in nonpregnant postmenarchal patients in whom no adnexal disorder is clinically known or suspected. It does NOT apply to patients with adnexal symptoms or positive pelvic physical examination findings. It does NOT apply to patients with higher genetic risk for ovarian cancer. It also presumes that the radiologist does NOT have access to prior relevant imaging or is unaware of the existence of prior relevant imaging. Comparison with prior imaging may obviate the need for follow-up imaging. Malignancy is effectively excluded in a lesion that is stable for 2 or more years. A lesion <= 1 cm is too small to be characterized. A lesion >=10 cm needs full characterization with MRI.

What are the characteristics of the cystic lesion?

Simple-appearing cyst < 10 cm                  

Other characteristic diagnosis            

Diagnosis uncertain or simple-appearing cyst >= 10 cm  

     
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Notes:  

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Simple-appearing cyst < 10 cm: Oval or round fluid density mass on CT or fluid signal cyst on MR without a solid component, with smooth, imperceptible, or thin walls.

Other characteristic diagnosis: Other adnexal masses with imaging features that are characteristic for a particular diagnostic entity such as hemorrhagic corpus luteal cysts, para-ovarian or paratubal cysts, hydrosalpinges, peritoneal inclusion cysts, ovarian fibromas, subserosal or pedunculated uterine leiomyomas, endometriomas, and dermoids.