Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Geffen School of Medicine at UCLA, Los Angeles, CA 90048, USA.
Best Pract Res Clin Endocrinol Metab. 2012 Feb;26(1):105-16. doi: 10.1016/j.beem.2011.07.002.
Incidental adnexal masses occur with relatively high frequency in post-menopausal women, with a prevalence rate of 3.3-18% in asymptomatic patients. Unilocular, benign-appearing ovarian cysts represent the vast majority of abnormal findings at transvaginal ultrasonography. As many as 80% will resolve over a period of several months; if persistent, unchanged, less than 10 cm, and with normal CA-125 values, the likelihood of an invasive cancer is sufficiently low that observation should be offered. More recent investigations support the use of secondary imaging modalities such as MRI, which may help differentiate benign from malignant masses. Surgical management plays a key role when patients are symptomatic regardless of age, menopausal and have documented changes in cyst characteristics, experience elevations in tumor markers or have symptoms suggestive of a hormone-producing neoplasm. High level, evidence-based screening guidelines have yet to be developed.
绝经后妇女的附件偶然肿块发生率相对较高，无症状患者的患病率为 3.3-18%。经阴道超声检查显示，大多数单侧、良性表现的卵巢囊肿是异常发现。多达 80%的囊肿会在几个月内自行消退；如果持续存在、不变、小于 10cm 且 CA-125 值正常，则侵袭性癌症的可能性非常低，可以选择观察。最近的研究支持使用 MRI 等辅助成像方式，这有助于区分良性和恶性肿块。当患者出现症状时，无论年龄、绝经状态如何，以及记录到囊肿特征变化、肿瘤标志物升高或有激素分泌肿瘤的症状时，手术治疗都起着关键作用。目前尚未制定出基于高证据水平的筛查指南。
