A 42-year-old woman is found to have an incidental adnexal mass on ultrasound performed for pelvic pain. The mass is 5 cm, multilocular with thin sept...

Question

A 42-year-old woman is found to have an incidental adnexal mass on ultrasound performed for pelvic pain. The mass is 5 cm, multilocular with thin septa, no solid components, and no ascites. Her CA-125 is 22 U/mL. She is premenopausal. What is her Risk of Malignancy Index (RMI) classification and appropriate management?

Accepted Answer

Low RMI - the cyst has benign features and can be managed conservatively with repeat ultrasound in 3-6 months

Answer

High RMI - refer on a 2-week wait suspected cancer pathway

Answer

Moderate RMI - refer urgently for laparotomy

Answer

High RMI - arrange CT staging before referral

Answer

The RMI cannot be calculated without a menopausal score

uk-drcog MCQ (SBA): Risk of Malignancy Index Calculation