CA125 is the gold standard tumor marker in the evaluation of pelvic masses, particularly in the ovarian epithelial cancer, elevated in over 90% of patients with advanced epithelial ovarian cancer and 40% of overall cases with advanced intraabdominal malignancies with a cutoff value of 9 more than 35 IU considered as malignant But it has been seen that elevated serum CA125 ( greater than 35IU/ml) could be found in many benign condition such as menstruation, pregnancy, functional cyst
, pelvic infection, and end- 9,10 ometriosis .
If repeated aspiration is unsuccessful, cyst is symptomatic or a functional cyst
is present, surgical resection is the best option (3,4,Z).
If there is no evidence of a dermoid cyst at that time, that cyst can be presumed to have been a functional cyst
, and patients can seek medical attention as needed.
A functional cyst
such as a follicular cyst, corpus luteum cyst, or theca lutein cyst usually has smooth borders and a fluid center.
51) Ovarian torsion occurs most commonly in the 1st and 2nd trimesters, attributable to increased ligamentous laxity, rapid uterine growth, and a greater number of functional cysts
present in early pregnancy.
Adnexal masses are commonly physiologic or functional cysts
, also known as "simple" cysts, may grow as large as 4 to 5 cm in diameter (FIGURE a, page 49).
PCOS occurs when multiple functional cysts
occur simultaneously as a result of irregular ovulation; symptoms include menstrual irregularities and excessive hair growth.
Because OCs with 20 [micro]g of estrogen or less may allow for increased follicular activity and may not always suppress ovulation, use of these vecy-low-close OCs may be associated with an increased risk for the development of functional cysts
and for breakthrough ovulation, Dr Rosenfeld said.
The most common pregnancy associated adnexal masses were functional cysts
like the corpus luteal cyst and theca lutein cysts.
Hemorrhagic cysts can mimic endometrioma; however, functional cysts
lack T2 shortening, a feature of endometriomas from repeated bleed.
Non-neoplastic masses include functional cysts
and neoplastic lesions include benign and malignant tumors of the ovary.