Does my mother’s ovarian cyst need to be removed?

Q: My 49 years old mother is going through menopause. Recently, her ultrasound revealed that she had an aechoic cyst of size 3.1 x2.6 cm in the left ovary. She is a diabetic too. Is the cyst very dangerous and does it needs to be removed?

A:She needs to have follow-up scans - transvaginal and estimation of CA125 level. If the cyst is small, clear and less than 6 cms, and CA 125 level normal- nothing more is required except follow-up scans for cyst size every 3 months. In case of any pain or fever - a complete blood count with ESR needs to be done- if ESR and WBC count are high - a vaginal swab can be done and infection treated. If cyst remains despite all these and there is pain, endometriosis needs to be ruled out by laparoscopy.