My mother is 50yrs old, had irregular periods for last 2 years, she is having an ovarian cyst (left sided) for last 3 years, which is persisting and is increasing in size (1st year it was 3cms in size, 2nd year it was 4.2cms and now it 5.1cms in size), her CA 125 is normal. The cyst appears clear on ultrasound. She also had D&C done one month back and histopathology report shows necrotic debri in cervix and had hyperplastic endometrial polyp (which was removed). Pap smear done during D&C shows ASCUS but her repeat pap smear was showing no evidence of cancer and her HPV test was also negative. Does she need hysterectomy or can be treated medically? If she can be treated medically than what treatment should be given? If CA 125 is negative, is there any chance that the cyst can get malignant?