[Skip to Navigation]
Invited Commentary
January 2019

Evaluating an Asymptomatic Adnexal Cyst Found on Pelvic Ultrasonography

Author Affiliations
  • 1Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
JAMA Intern Med. 2019;179(1):78-79. doi:10.1001/jamainternmed.2018.5133

Pelvic ultrasonography is a wonderful tool for assessing women presenting with pelvic pain, reporting abnormal bleeding, or having a suspected pelvic mass. However, as a screening tool for ovarian cancer, pelvic ultrasonography is limited for the following reasons: (1) the low incidence of ovarian cancer (a 1 in 80 lifetime risk); (2) the normal physiologic activity of the ovaries, where cysts are often seen, and due to size or appearance lead to more follow-up imaging; and (3) the likelihood of finding benign but nonphysiologic adnexal cysts, which lead to further imaging or surgery, without necessarily leading to improved patient outcomes. Therefore, guidelines recommend follow-up for only certain types of adnexal cysts.1-4 It is well recognized that simple adnexal cysts (thin-walled round or oval cysts with anechoic fluid and through transmission) are almost always benign, but there is hesitancy to ignore these common cysts and not recommend follow-up, particularly when cysts are large or when the patient is postmenopausal. It is with this background that the article by Smith-Bindman et al5 advances our knowledge.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words