Ovarian follicular cyst
An ovarian follicular cyst is type of simple physiological ovarian cyst.
The terms "ovarian cyst" and "ovarian follilcular cyst" are often used interchangeably. These two terms describe lesions >3 cm, and it is important to differentiate them from an "ovarian follicle" which is <3 cm.
They present in women of reproductive age.
They are asymptomatic and frequently present on routine pelvic scans.
They generally resolve spontaneously in two to three cycles.
- thin walled and unilocular
- usually range around 3 to 8 cm in size
- by definition, if <3 cm it is an ovarian follicle rather than an ovarian follicular cyst
- there is typically posterior acoustic enhancement and an absence of internal echoes
- there should be no colour flow, nodules or or any solid components.
Treatment and prognosis
Small, simple presumed follicular cysts (<5 cm) in premenopausal patients can be left alone and require neither surgery nor imaging follow-up. According to a recent consensus statement 6, yearly followup is suggested for cysts 5-7 cm, and large cysts (>7 cm) should ideally be assessed with MRI to exclude any subtle worrisome features, as it may be difficult to visualise these entirely with ultrasound.
Follicular cysts do not occur in postmenopausal women. A cystic ovarian lesion in a postmenopausal woman requires different follow-up (see ovarian cyst)
- 1. Atri M, Nazarnia S, Bret PM et-al. Endovaginal sonographic appearance of benign ovarian masses. Radiographics. 1994;14 (4): 747-60. Radiographics (abstract) - Pubmed citation
- 2. Fakhry J, Khoury A, Kotval PS et-al. Sonography of autonomous follicular ovarian cysts in precocious pseudopuberty. J Ultrasound Med. 1988;7 (11): 597-603. J Ultrasound Med (abstract) - Pubmed citation
- 3. M.D. CB. Ultrasonography in Obstetrics and Gynocology, A practical approach. Thieme. (2007) ISBN:1588906124. Read it at Google Books - Find it at Amazon
- 4. Bluth EI. Ultrasound, a practical approach to clinical problems. Thieme Publishing Group. (2008) ISBN:3131168323. Read it at Google Books - Find it at Amazon
- 5. Merz E. Ultrasound in obstetrics and gynecology, Gynecology. Thieme Publishing Group. (2007) ISBN:3137544025. Read it at Google Books - Find it at Amazon
- 6. Levine D, Brown DL, Andreotti RF et-al. Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology. 2010;256 (3): 943-54. doi:10.1148/radiol.10100213 - Pubmed citation