A 35-year-old patient on USG shows 3×4 cm clear ovarian cyst on right side. Next line of management is:
Ovarian cysts in reproductive-age women are often functional, like follicular or corpus luteum cysts. They're usually benign and may resolve on their own. The size here is 3x4 cm, which is relatively small. The key factors to consider are the size, symptoms, and any suspicious features on imaging. Since the cyst is described as "clear," that suggests it's simple and not complex, which is a good sign.
The next step would typically be to monitor the cyst with a follow-up ultrasound in a few weeks because many functional cysts resolve without intervention. If the cyst persists or shows any concerning features like solid components, papillary projections, or if the patient has symptoms like pain or irregular bleeding, further evaluation with CA-125 or even surgery might be needed. But in this case, since it's small and simple, observation is the way to go.
Now, the options aren't provided, but common distractors might include immediate surgery, hormonal therapy, or unnecessary tests. For example, if an option says "laparoscopic removal," that's probably incorrect unless there are signs of torsion or malignancy. Another wrong option might be starting oral contraceptives immediately, which isn't the first step unless the cyst is persistent and causing symptoms. Also, if someone suggests a CT scan, that's not the standard imaging for ovarian cysts; ultrasound is preferred.
Clinical pearls: Remember that simple, small ovarian cysts in women of reproductive age are often functional and may resolve spontaneously. Follow-up imaging is key. Surgery is reserved for larger cysts, persistent ones, or those with suspicious features. CA-125 isn't routinely used unless there's a concern for malignancy, especially in postmenopausal women.
So the correct answer is likely to recommend a follow-up ultrasound. The wrong options would be incorrect because they either over-treat or use inappropriate methods. The clinical pearl is the follow-up imaging for small, simple cysts.
**Core Concept**
Ovarian cysts in reproductive-age women are often functional (follicular/corpus luteum) and resolve spontaneously. Management depends on cyst size, complexity, and clinical context. Simple, small cysts (5 cm, persistent for >2 cycles, or with torsion/malignancy features.
**Option B:** *Oral contraceptive