# Ovarian Cyst — GCMD Library living collection

Everything in the library about ovarian cyst — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 41 cited statements

## Episodes
### Case-Based Learning
- [Ovarian Salvage (Torsion & Benign Tumor): Practice Gap discussion at Update...](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344) — video · 14:07 · [machine version](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344.md)
- [Ovarian Torsion Rapid Fire: Update Course 2015](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981) — video · 12:46 · [machine version](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981.md)

### In-Depth Reviews
- [Ovarian Cysts with Dr. Roshni Dasgupta](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665) — video · [machine version](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=0) Case presentation and ultrasound limitations in ovarian torsion (Ep 1)
- [3:00](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=180) Management of necrotic ovaries and the decision to preserve versus remove (Ep 1)
- [7:29](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=449) Managing ovarian masses in the setting of torsion (Ep 1)
- [12:12](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=732) Technical considerations and summary teaching points (Ep 1)
- [0:01](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=1) Ovarian preservation in torsion: evidence and technique (Ep 2)
- [5:38](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=338) Surgical timing and the role of ultrasound Doppler (Ep 2)
- [10:32](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=632) Oophoropexy techniques and bilateral fixation (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=0) Neonatal ovarian cysts: prenatal diagnosis and initial management (Ep 3)
- [2:06](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=126) Surgical indications and management of persistent or complex cysts (Ep 3)
- [4:10](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=250) Closing remarks (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Ultrasound is a horrible test for torsion according to a pediatric radiologist who was president of the Pediatric Radiology Society" (host_summary) [Ep 1 · 0:46](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=46)
- "Ultrasound is good at identifying the mass and enlarged ovary but should never provide comfort that torsion is not present" (clinical) [Ep 1 · 1:07](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=67)
- "The presence or absence of flow to the ovary on ultrasound should not provide comfort that the patient does not have torsion" (clinical) [Ep 1 · 1:07](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=67)
- "Ultrasound for ovarian torsion is a coin flip in terms of whether vascular flow is seen" — Todd Ponsky (host_summary) [Ep 1 · 1:29](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=89)
- "Black, apparently dead ovaries should be left in place after detorsion" (host_summary) [Ep 1 · 2:35](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=155)
- "A study is underway to improve diagnostic accuracy for torsion and create a scoring system to decrease negative laparoscopies" (clinical) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=180)
- "In 2018, there is no better diagnostic test for torsion than clinical suspicion leading to laparoscopy" (clinical) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=180)
- "When an ovary is malignant, removal is appropriate" — Todd Ponsky (host_summary) [Ep 1 · 5:01](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=301)
- "Clinical assessment at the time of operation is unreliable in determining the presence of viable ovarian cortical tissue" — Todd Ponsky (host_summary) [Ep 1 · 6:18](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=378)
- "Serial ultrasounds after leaving black ovaries in place have shown follicles, indicating functional ovarian tissue was present" — Todd Ponsky (clinical) [Ep 1 · 6:18](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=378)
- "For a torsed ovary with a dermoid cyst, the strategy is to detorse, leave the mass in situ, follow with ultrasound to see if the ovary survives, and return to remove the cyst if it does" (clinical) [Ep 1 · 7:29](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=449)
- "Ultrasound follow-up over approximately 6 weeks is used to determine if a detorsed ovary survives" (clinical) [Ep 1 · 7:29](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=449)
- "Kate Dean has funding from the Thrasher Foundation through the Midwest Pediatric Surgeon Consortium to study an algorithm using tumor markers, size, and radiologic confirmation to determine if ovarian masses are benign" — Todd Ponsky (host_summary) [Ep 1 · 9:10](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=550)
- "Masses in association with ovarian torsion occur in approximately 20% of cases" (epidemiological) [Ep 1 · 11:02](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=662)
- "The risk of malignancy in ovarian masses associated with torsion is very low" (epidemiological) [Ep 1 · 11:02](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=662)
- "The strategy for torsion with a mass is to detorse the ovary, and if the mass can be dealt with at that time with ovarian-sparing surgery, that is acceptable; otherwise close and return after monitoring" (clinical) [Ep 1 · 11:02](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=662)
- "There is no urgency in deciding about mass removal; tumor markers can be obtained, the case can be taken to tumor board, and the decision can be made in a non-emergent fashion" — Todd Ponsky (clinical) [Ep 1 · 11:49](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=709)
- "Laparoscopic ovarian-sparing mass resection has technical challenges; a Pfannenstiel incision may be easier for palpation and dissection" (clinical) [Ep 1 · 12:12](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=732)
- "In ovarian torsion, detorsion should be addressed first, and the mass is a separate issue to be dealt with using ovarian-sparing surgery" (clinical) [Ep 1 · 12:49](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=769)
- "If a Pfannenstiel incision is needed to accomplish ovarian-sparing surgery, that is preferable to oophorectomy" (clinical) [Ep 1 · 12:49](https://library.globalcastmd.com/watch/ovarian-salvage-practice-gap-discussion-at-update-344?t=769)
- "Ovarian torsion is most common in teenage girls and is being seen as an urgent rather than emergent situation when aiming to preserve the ovary." — Andrea (clinical) [Ep 2 · 0:01](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=1)
- "Many black-colored ovaries actually have viable follicles in them, and ovarian preservation should be the goal." — Andrea (clinical) [Ep 2 · 1:40](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=100)
- "In oophorectomy specimens removed for torsion where the surgeon believed the ovary was dead, 76% had normal ovarian tissue, only 13% had no ovarian tissue, and only 11% were completely necrotic." — Andrea (epidemiological) [Ep 2 · 3:20](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=200)
- "Microscopically, ovarian tissue looks very different than it does in the gross setting when a surgeon is looking at the ovary." — Andrea (clinical) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=240)
- "Pain is the most commonly reported consequence of oophoropexy, which is usually short-lived and resolves in about a week." — Andrea (clinical) [Ep 2 · 4:20](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=260)
- "The ability to preserve ovarian function is related to age; in pediatric patients, surgeons should be aggressive about preserving the ovary, but in older adults there are fewer active follicles." — Andrea (clinical) [Ep 2 · 4:40](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=280)
- "The recommendation is for detorsion without complete oophorectomy." — Andrea (guideline) [Ep 2 · 5:20](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=320)
- "Ultrasound sensitivity and specificity for blood flow in ovarian torsion is in the 50-60% range." — Andrea (epidemiological) [Ep 2 · 8:16](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=496)
- "If the child is in a lot of pain, surgery needs to be done right away; ultrasound blood flow findings should not be relied upon." — Andrea (opinion) [Ep 2 · 8:30](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=510)
- "Pediatric radiologists, including presidents of their national organization, have stated that ultrasound does not help in the setting of suspected ovarian torsion." (host_summary) [Ep 2 · 7:59](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=479)
- "If an ovary is twisted, just because there's blood flow doesn't mean it's not twisted; it may mean at that point in time it might not be so tight, but a minute later it could be tight again." — Todd Ponsky (host_summary) [Ep 2 · 9:44](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=584)
- "Ultrasound blood flow findings are dependent on the pressure the sonographer is using and how much the bladder is filled." — Andrea (clinical) [Ep 2 · 10:22](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=622)
- "For fertility reasons, placing ovaries behind the uterus during oophoropexy is preferred over lateral placement." (opinion) [Ep 2 · 11:29](https://library.globalcastmd.com/watch/ovarian-torsion-rapid-fire-update-course-2015-981?t=689)
- "Ovarian pathology can affect children at all stages of life, with differential and workup differing based on age of presentation and size of mass." (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=0)
- "Cysts diagnosed prenatally have a differential including ovarian cyst, mesenteric cyst, duplication cyst, complex meconium cyst, or renal cyst." — Roshni Dasgupta (clinical) [Ep 3 · 0:25](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=25)
- "There is not much to do in utero for prenatally diagnosed pelvic cysts." — Roshni Dasgupta (clinical) [Ep 3 · 1:00](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=60)
- "For a thriving neonate with a truly cystic mass, serial imaging at about 12 weeks is appropriate if it is a simple cyst, which should get smaller in that timeframe." — Roshni Dasgupta (clinical) [Ep 3 · 1:10](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=70)
- "If abnormal ovaries or no ovaries are seen on imaging, intrauterine torsion may have occurred, leaving a free floating cyst." — Roshni Dasgupta (clinical) [Ep 3 · 1:35](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=95)
- "Prenatal ovarian cysts are really common and usually diagnosed around 28 weeks gestation." (epidemiological) [Ep 3 · 2:06](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=126)
- "Prenatal ovarian cysts are rarely associated with malignancy and most go away by themselves." (clinical) [Ep 3 · 2:25](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=145)
- "Indications for surgery include development of symptoms, cysts over 5 centimeters (increased risk of torsion), or persistence for greater than 6 months with no decrease in size." (clinical) [Ep 3 · 2:35](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=155)
- "If a cyst persists for greater than 6 months with no decrease in size, it may not be part of the ovary and could be a mesenteric cyst or something else requiring further investigation." (clinical) [Ep 3 · 3:05](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=185)
- "In adolescence, the same rules apply for ovarian cysts, with main concern being size due to increased risk of torsion, and serial imaging can be used." (clinical) [Ep 3 · 3:20](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=200)
- "Other kinds of ovarian cysts found in adolescence can be pretty large, composed of granulosa and thecal cells, and can cause torsion." (clinical) [Ep 3 · 3:35](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=215)
- "When ovarian cysts are seen incidentally during appendicitis workup, they should be left alone and followed with ultrasound in about 6 weeks." (clinical) [Ep 3 · 3:50](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=230)
- "Paraovarian cysts are hard to differentiate from follicular cysts on imaging." — Roshni Dasgupta (clinical) [Ep 3 · 4:02](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=242)
- "The big concern with paraovarian cysts is torsion of the fallopian tube itself, not just the ovary." — Roshni Dasgupta (clinical) [Ep 3 · 4:10](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=250)
- "Paraovarian cysts are usually in the mesosalpinx." — Roshni Dasgupta (clinical) [Ep 3 · 4:20](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=260)
- "If paraovarian cysts are greater than 3 centimeters, enucleation is recommended to prevent torsion of the tube." — Roshni Dasgupta (clinical) [Ep 3 · 4:25](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=265)
- "If paraovarian cysts are smaller than 3 centimeters, most people do not intervene, but they can be opened and drained if desired." — Roshni Dasgupta (opinion) [Ep 3 · 4:35](https://library.globalcastmd.com/watch/ovarian-cysts-with-dr-roshni-dasgupta-5665?t=275)

## Changelog
- Sep 25: 3 items added automatically

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