Introduction Functional ovarian cysts ovarian follicular cysts corpus luteal cysts theca lutein cysts Other cysts dermoid cyst/teratoma endometriomas/chocolate cysts Evaluation ultrasound, CT or MRI Complications rupture or hemorrhage can cause peritonitis ovarian torsion often presents with nausea/vomiting and sharp, sudden lower abdominal pain caused by twisting of the infundibulopelvic ligament Follicular Cyst Most common ovarian mass in women of reproductive age Non-neoplastic expansion of an unruptured graafian follicle Associated with hyperestrogenism and endometrial hyperplasia Evaluation with ultrasound thin walled unilocular Treatment large (>5cm) or symptomatic may undergo surgical resection small asytompatic cysts managed conservatively Corpus Luteal Cyst Failure of corpus luteum to regress after ovum release Most common pelvic mass within 1st trimester of pregnancy Can result in complicating hemorrhage or rupture Evaluation with ultrasound diffuse thick wall peripheral vascularity/ "ring of fire" Theca-Lutein Cyst Excessive circulating gonadotropins (beta-hcG) causes hyperplasia of theca interna cells Often bilateral and multicystic Associations with gonadotropin stimulation multifetal pregnancy PCOS clomiphene intake ovulation induction gestational trophoblastic disease Dermoid cyst/ Teratoma Also known as mature cystic ovarian teratoma Most common ovarian neoplasm Contain elements from multiple germ layers (e.g. hair, skin or teeth) Slow growing and rarely cancerous Variant struma ovarii tumor: contains thyroid elements Endometrioma/ "Chocolate Cyst" Endometriosis of the ovaries Histopathology required for definitive diagnosis Hormonal changes during menstrual cycle varies size Treatment NSAID hormonal contraception progestational agents or GnRH agonists surgery