Watch & wait with small simple cysts.(Gynecology)

KAILUA KONA, HAWAII -- The proliferation of CT scans by internists and other physicians has brought an increasing number of incidental findings of post-menopausal ovarian cysts, Dr. William J. Hoskins said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

Before the widespread use of CT scans and ultrasonography, "we thought that postmenopausal women didn't get ovarian cysts, and if they did, they were bad" cysts. "Now we know that finding a simple ovarian cyst in a postmenopausal patient is a relatively common thing," he said.

Clinicians also have learned that it's okay to follow simple ovarian cysts less than 6 cm in diameter in postmenopausal women because if the cyst stays stable or decreases in size, the chances of its being a malignancy are extraordinarily small, said Dr. Hoskins, professor of obstetrics and gynecology at Mercer University, Savannah, Ga.

No one really knows how long to follow a small cyst, but most experts suggest 1 year, he added. Check it after 6 weeks, and again at 3 months, 6 months, and 1 year. If it grows or changes from a simple to a complex cyst, conventional wisdom--based on relatively good data--suggests that the patient needs surgery, Dr. Hoskins said.

The "vast majority" of simple postmenopausal cysts on the ovaries will be 2-3 ...