A 61 years old post-menopausal woman with a family history of ovarian cancer presents with pain abdomen. She is on hormone replacement therapy. An abdominal ultrasound revealed a smooth cyst in the right ovary. What should be done next?
Observe and reassure the patient
Laparoscopic surgery to visualize the nature of the cyst
Drilling of cysts
Check CA-125 levels and advise regular follow-up if normal
Answer-D. Check CA-125 levels and advise regular follow-up if normalThis is a post-menopausal patient with a simple (smooth) qtst in the ovary. Such a cyst doesn't needfuher investigations,but this patient has two risk factors for malignancy: Family history of ovarian tamor and history of Hormonal therapy.Hence, CA-125 levels should be evaluated and the RMI-I score (Risk of Malignancy index) calcalated before proceedingfor regular follow up. If RMI score exceeds 200,fuher imaging laparoscopic surgery will be needed in this patient.