Is follow-up required after oophorectomy with a pathology report showing serous cystadenoma?

From the Guidelines

No specific follow-up is typically required after an oophorectomy with pathology showing a serous cystadenoma, as these are benign ovarian tumors. A routine post-operative visit at 2-4 weeks is standard to ensure proper healing and to discuss the pathology results. Since serous cystadenomas are not precancerous and have no malignant potential, no additional surveillance, imaging, or tumor marker testing is needed beyond regular gynecologic care 1. If the patient has not undergone bilateral oophorectomy, routine gynecologic examinations should continue as recommended for age-appropriate care to monitor the remaining ovary. Patients who have had both ovaries removed before natural menopause may need hormone replacement therapy to manage menopausal symptoms and prevent bone loss, which should be discussed with their healthcare provider 1. The excellent prognosis can be reassuring for patients, as these benign tumors do not recur after complete surgical removal and have no impact on long-term health or survival.

Some key points to consider:

• Simple cysts, regardless of size and menopausal status, are not associated with an increased risk of cancer 1
• Invasive serous cystadenocarcinoma is now thought to primarily originate from solid precursors in the fallopian tube and serous tubal intraepithelial carcinoma, further supporting the benignity of simple ovarian cysts 1
• The American College of Obstetricians and Gynecologists Committee on Practice Bulletins—Gynecology, has recommended that “Simple cysts up to 10 cm in diameter on transvaginal ultrasonography performed by experienced ultrasonographers are likely to be benign and may be safely monitored using repeat imaging without surgical intervention, even in postmenopausal patients” 1
• The O-RADS US risk stratification and management system provides a framework for evaluating and managing adnexal masses, but serous cystadenomas are generally considered benign and do not require specific follow-up 1

From the Research

Follow-up Requirements after Oophorectomy

• The necessity of follow-up after oophorectomy with a pathology report showing serous cystadenoma is not explicitly stated in the provided studies, as they primarily focus on the characteristics and management of serous cystadenomas in different contexts 2, 3, 4, 5, 6.
• However, it can be inferred from the studies that serous cystadenomas are generally considered benign lesions, and their management may not require aggressive follow-up 2, 6.
• A study on pancreatic serous cystadenomas suggests that these lesions tend to follow a benign and asymptomatic course, with minimal size change during follow-up 2.
• In the context of ovarian serous cystadenomas, a case report highlights the rare occurrence of ectopic adrenal tissue, which may pose a risk of neoplastic transformation, but does not provide guidance on follow-up requirements 3.
• Another study on ovarian serous cystadenoma with massive ovarian edema recommends conservative treatment and ovarian suspension when histology suggests a benign lesion, implying that follow-up may be necessary to monitor for potential complications 5.
• Overall, while the provided studies do not directly address the question of follow-up requirements after oophorectomy with a pathology report showing serous cystadenoma, they suggest that these lesions are generally benign and may not require aggressive management or follow-up 2, 3, 4, 5, 6.