Ovarian Cysts Referral Information
Information on ovarian cyst assessment, RMI scoring, and referral management pathways.
Ovarian Cysts
Referrals for ovarian cysts will be triaged according to symptomatology and risk of malignancy. Lesions suspicious for ovarian cancer will be managed urgently by the Gynaecology Oncology Specialists.
CA125 and transvaginal ultrasound scan findings should be included in referrals, as well as significant personal or family history (ovarian, bowel or breast cancer).
RMI Score Guide
The RMI score (malignancy risk index) is calculated based on the serum CA 125 value, menopausal status (M), and evaluation of ultrasound (U).
RMI = U x M x s-CA 125
In general, lesions with RMI > 200 have a high index of suspicion for cancer.
Asymptomatic, simple, unilateral, unilocular ovarian cysts, less than 5 cm in diameter, have a low risk of malignancy. In the presence of normal serum CA125 levels, these cysts can be managed conservatively, with a repeat evaluation in 4–6 months.
Ultrasound features (U)
Multilocular Cyst 1
Solid Areas 1
Bilateral Lesions 1
Ascites 1
Metatastes 1
Menopausal Status (M)
Premenopause 1
Postmenopause 3