Background: Ultrasound-guided puncture is a simple and easy to perform procedure. This study was undertaken to verify the role of fine-needle aspiration (FNA) followed by cytological examination as a possible alternative to surgery in case of cystic pelvic masses. Ovarian cysts are conventionally managed by laparoscopy or laparotomy.
Methods: From January 1993 to December 1997, 224 patients with a proven cystic pelvic mass underwent surgical intervention and have been retrospectively analysed for FNA under sonographic guidance. The sediment aspirated was examined by a cytological method and when possible it was also correlated to a histological test.
Results: Eight patients (34.8%) had been submitted to one needle cyst aspiration before surgical intervention and 15 (65.2%) to more than one aspiration. Patients with an history of only one aspiration were submitted to surgical intervention with urgency statistically more than the group with an history of more than one aspiration. Anatomo-pathologic examination showed a significative relevance of serous and endometriotic cysts.
Conclusions: We conclude that FNA might be proposed in young women with a unilocular ovarian cyst to avoid a surgical procedure. In all instances the ultrasonographic appearance of the cyst and the characteristics of aspirated fluid are the most important findings.