In the post-menopausal group, I would say 50 percent of those are going to have a cancer risk associated with the cyst, and certainly as one gets older than 50, that increase goes markedly up. Certainly if a 75-year-old woman came in with any type of cyst, that should be looked into aggressively. So the problem in management really is when you have a prepubital girl who comes in and has a documented large cyst, you're going to operate. The post-menopausal woman is going to be followed very aggressively and most likely, she's going to be operated on. The key in management is, the challenge is, well how do you manage the reproductive age group? Which is the majority of where these cysts show up and we'll talk about here, that in a minute. But I want to say something about the size of cysts. And a cyst depends on your definition. We've already said that a cyst is a fluid filled sac, but how big is it? Clearly it's any size, but most likely a cyst is going to be visible if it's about a centimeter. What is considered as a cyst that bears watching is usually something at three centimeters or greater. And if you have a cyst six centimeters, which is for the non-metric group, sometimes I have to check myself, the, it's about a little over two-and-a-third inches. If a woman presents with a cyst that's two-and-a-third inches, that bears definite watching and rather aggressive management. Indiana University trained Obstetrician Gynecologist, Christopher Freville suggests that certainly very large cysts have the necessity for more aggressive, aggressive management. more...
