For an ovarian cyst greater than 8 cm or persistent in a non-postmenopausal patient, what is recommended?

• A. Medical therapy
• B. Observation
• C. Hormonal therapy
• D. Laparoscopy or laparotomy

Answer: (D)

A large or persistent ovarian cyst in a non-postmenopausal patient should be managed surgically because size and ongoing presence raise concern for neoplasm and can lead to complications like torsion or rupture. Medical or hormonal therapy won’t reliably resolve a cyst of this size or persistence, and observing it alone risks missing a malignant process. The recommended approach is laparoscopy or laparotomy to remove the cyst (or perform a cystectomy/oophorectomy as indicated) and obtain a definitive pathology diagnosis. Preoperative imaging and tumor markers help assess risk, but definitive management hinges on surgical evaluation and treatment.