Hello and welcome, I understand your concern. A cyst in the age of 48 needs evaluation. However most of the cysts are non cancerous. The size of the cyst is less than 5 centimeters which is more in favor of it being non cancerous. It would help if you could upload other features of the cyst like thickness, complexity, presence of solid component and so on as they are helpful in taking a call. Certain tests are used to get an idea about the malignant nature of the cysts. These are called tumor markers. CA 125 is one such marker commonly found in ovarian cancer. So get it done. A positive report is more in favor of cancer but a negative report does not rule out cancer. Still we advise it. Other features of cancer are a rapid increase in size, hard to palpation. These can be detected by serial ultrasound and physical examination by a doctor. The most confirmatory test to rule out a malignancy is cystectomy that is removing it and testing for cancer. I suggest that you get the above tests done and then discuss the possibilities with your doctor. As of now it seems to be non cancerous from the above information. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist