These minimally complex cysts
are also generally considered benign, but there are reports in the literature of category II lesions being malignant (Table 2).
The characteristics of women with simple and complex cysts
, including anthropometric parameters and hormones levels, are presented in Table 1.
Sonography depicts focal endometriomas as complex cysts
with homogenous, low-level internal echoes.
The Bosniak system consists of four categories based on triphasic CT findings, ranging from simple to complex cysts
They can also identify complex cysts
and solid masses, which require further evaluation.
Also, 4 in 5 of ovarian cysts persisting into the second trimester will also be present in the post-natal period as complex cysts
such as serous cystadenomas, mature cystic teratomas, endometriomas and mucinous cystadenomas (3).
One should be aware of complex cysts
which may represent a breast malignancy, typically a papillary cystic carcinoma.
However, their role is still debatable as some studies claim less morbidity, (18) while others do not recommend a laparoscopic approach for complex cysts
(19) and warn that cysts larger than 8 cm in diameter have higher risk of spillage of daughter cysts and development of secondary Echinococcosis (20) Moreover, it is shown that open approach has the advantage of allowing the surgeon to explore the peritoneal cavity (7).