Ovarian cyst prognosis: Ovarian cysts – Symptoms and causes
What is Ovarian Cancer | Ovarian Tumors and Cysts
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread. To learn more about how cancers start and spread, see What Is Cancer?
Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes.
What are the ovaries?
Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus.
The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor:
- Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
- Germ cell tumors start from the cells that produce the eggs (ova).
- Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
Some of these tumors are benign (non-cancerous) and never spread beyond the ovary. Malignant (cancerous) or borderline (low malignant potential) ovarian tumors can spread (metastasize) to other parts of the body and can be fatal.
Epithelial ovarian tumors
Epithelial ovarian tumors start in the outer surface of the ovaries. These tumors can be benign (not cancer), borderline (low malignant potential), or malignant (cancer).
Benign epithelial ovarian tumors
Epithelial ovarian tumors that are benign don’t spread and usually don’t lead to serious illness. There are several types of benign epithelial tumors including serous cystadenomas, mucinous cystadenomas, and Brenner tumors.
Borderline Epithelial Tumors
When looked at in the lab, some ovarian epithelial tumors don’t clearly appear to be cancerous and are known as borderline epithelial ovarian cancer. The two most common types are
atypical proliferative serous carcinoma and atypical proliferative mucinous carcinoma. These tumors were previously called tumors of low malignant potential (LMP tumors). These are different from typical ovarian cancers because they don’t grow into the supporting tissue of the ovary (called the ovarian stroma). If they do spread outside the ovary, for example, into the abdominal cavity (belly), they might grow on the lining of the abdomen but not into it.
Borderline tumors tend to affect younger women than the typical ovarian cancers. These tumors grow slowly and are less life-threatening than most ovarian cancers.
Malignant epithelial ovarian tumors
Cancerous epithelial tumors are called carcinomas. About 85% to 90% of malignant ovarian cancers are epithelial ovarian carcinomas. These tumor cells have several features (when looked at in the lab) that can be used to classify epithelial ovarian carcinomas into different types. The serous type is by far the most common, and can include high grade and low grade tumors. The other main types include mucinous, endometrioid, and clear cell.
- Serous carcinomas (52%)
- Clear cell carcinoma (6%)
- Mucinous carcinoma (6%)
- Endometrioid carcinoma (10%)
Each ovarian cancer is given a grade, based on how much the tumor cells look like normal tissue:
- Grade 1 epithelial ovarian carcinomas look more like normal tissue and tend to have a better prognosis (outlook).
- Grade 3 epithelial ovarian carcinomas look less like normal tissue and usually have a worse outlook.
Other traits are also taken into account, such as how fast the cancer cells grow and how well they respond to chemotherapy, to come up with the tumor’s type:
- Type I tumors tend to grow slowly and cause fewer symptoms. These tumors also seem not to respond well to chemotherapy. Low grade (grade 1) serous carcinoma, clear cell carcinoma, mucinous carcinoma and endometrioid carcinoma are examples of type I tumors.
- Type II tumors grow fast and tend to spread sooner. These tumors tend to respond better to chemotherapy. High grade (grade 3) serous carcinoma is an example of a type II tumor.
Other cancers that are similar to epithelial ovarian cancer
Primary peritoneal carcinoma
Primary peritoneal carcinoma (PPC) is a rare cancer closely related to epithelial ovarian cancer. At surgery, it looks the same as an epithelial ovarian cancer that has spread through the abdomen. In the lab, PPC also looks just like epithelial ovarian cancer. Other names for this cancer include extra-ovarian (meaning outside the ovary) primary peritoneal carcinoma (EOPPC) and serous surface papillary carcinoma.
PPC appears to start in the cells lining the inside of the fallopian tubes.
Like ovarian cancer, PPC tends to spread along the surfaces of the pelvis and abdomen, so it is often difficult to tell exactly where the cancer first started. This type of cancer can occur in women who still have their ovaries, but it is of more concern for women who have had their ovaries removed to prevent ovarian cancer. This cancer does rarely occur in men.
Symptoms of PPC are similar to those of ovarian cancer, including abdominal pain or bloating, nausea, vomiting, indigestion, and a change in bowel habits. Also, like ovarian cancer, PPC may elevate the blood level of a tumor marker called CA-125.
Women with PPC usually get the same treatment as those with widespread ovarian cancer. This could include surgery to remove as much of the cancer as possible (a process called debulking that is discussed in the section about surgery), followed by chemotherapy like that given for ovarian cancer. Its outlook is likely to be similar to widespread ovarian cancer.
Fallopian tube cancer
This is another rare cancer that is similar to epithelial ovarian cancer. It begins in the tube that carries an egg from the ovary to the uterus (the fallopian tube). Like PPC, fallopian tube cancer and ovarian cancer have similar symptoms. The treatment for fallopian tube cancer is much like that for ovarian cancer, but the outlook (prognosis) is slightly better.
Ovarian germ cell tumors
Germ cells usually form the ova or eggs in females and the sperm in males. Most ovarian germ cell tumors are benign, but some are cancerous and may be life threatening. Less than 2% of ovarian cancers are germ cell tumors. Overall, they have a good outlook, with more than 9 out of 10 patients surviving at least 5 years after diagnosis. There are several subtypes of germ cell tumors. The most common germ cell tumors are teratomas, dysgerminomas, endodermal sinus tumors, and choriocarcinomas. Germ cell tumors can also be a mix of more than a single subtype.
Teratomas are germ cell tumors with areas that, when seen under the microscope, look like each of the 3 layers of a developing embryo: the endoderm (innermost layer), mesoderm (middle layer), and ectoderm (outer layer). This germ cell tumor has a benign form called mature teratoma and a cancerous form called immature teratoma.
The mature teratoma is by far the most common ovarian germ cell tumor. It is a benign tumor that usually affects women of reproductive age (teens through forties). It is often called a dermoid cyst because its lining is made up of tissue similar to skin (dermis). These tumors or cysts can contain different kinds of benign tissues including, bone, hair, and teeth. The patient is cured by surgical removal of the cyst, but sometimes a new cyst develops later in the other ovary.
Immature teratomas are a type of cancer. They occur in girls and young women, usually younger than 18. These are rare cancers that contain cells that look like those from embryonic or fetal tissues such as connective tissue, respiratory passages, and brain. Tumors that are relatively more mature (called grade 1 immature teratoma) and haven’t spread beyond the ovary are treated by surgical removal of the ovary. When they have spread beyond the ovary and/or much of the tumor has a very immature appearance (grade 2 or 3 immature teratomas), chemotherapy is recommended in addition to surgery.
This type of cancer is rare, but it is the most common ovarian germ cell cancer. It usually affects women in their teens and twenties. Dysgerminomas are considered malignant (cancerous), but most don’t grow or spread very rapidly. When they are limited to the ovary, more than 75% of patients are cured by surgically removing the ovary, without any further treatment. Even when the tumor has spread further (or if it comes back later), surgery, radiation therapy, and/or chemotherapy are effective in controlling or curing the disease in about 90% of patients.
Endodermal sinus tumor (yolk sac tumor) and choriocarcinoma
These very rare tumors typically affect girls and young women. They tend to grow and spread rapidly but are usually very sensitive to chemotherapy. Choriocarcinoma that starts in the placenta (during pregnancy) is more common than the kind that starts in the ovary. Placental choriocarcinomas usually respond better to chemotherapy than ovarian choriocarcinomas do.
Ovarian stromal tumors
About 1% of ovarian cancers are ovarian stromal cell tumors. More than half of stromal tumors are found in women older than 50, but about 5% of stromal tumors occur in young girls.
The most common symptom of these tumors is abnormal vaginal bleeding. This happens because many of these tumors produce female hormones (estrogen). These hormones can cause vaginal bleeding (like a period) to start again after menopause. In young girls, these tumors can also cause menstrual periods and breast development to occur before puberty.
Less often, stromal tumors make male hormones (like testosterone). If male hormones are produced, the tumors can cause normal menstrual periods to stop. They can also make facial and body hair grow. If the stromal tumor starts to bleed, it can cause sudden, severe abdominal pain.
Types of malignant (cancerous) stromal tumors include granulosa cell tumors (the most common type), granulosa-theca tumors, and Sertoli-Leydig cell tumors, which are usually considered low-grade cancers. Thecomas and fibromas are benign stromal tumors. Cancerous stromal tumors are often found at an early stage and have a good outlook, with more than 75% of patients surviving long-term.
An ovarian cyst is a collection of fluid inside an ovary. Most ovarian cysts occur as a normal part of the process of ovulation (egg release) — these are called functional cysts. These cysts usually go away within a few months without any treatment. If you develop a cyst, your doctor may want to check it again after your next menstrual cycle (period) to see if it has gotten smaller.
An ovarian cyst can be more concerning in a female who isn’t ovulating (like a woman after menopause or a girl who hasn’t started her periods), and the doctor may want to do more tests. The doctor may also order other tests if the cyst is large or if it does not go away in a few months. Even though most of these cysts are benign (not cancer), a small number of them could be cancer. Sometimes the only way to know for sure if the cyst is cancer is to take it out with surgery. Cysts that appear to be benign (based on how they look on imaging tests) can be observed (with repeated physical exams and imaging tests), or removed with surgery.
Ovarian Fibroma & Fibroid Treatment
Aside from endometriosis and congenital anomalies, ovarian cysts and fibroids are two more common conditions that can impact fertility and a woman’s ability to conceive.
Ovarian cysts are fluid-filled cavities within the ovary that may develop as part of the follicle which forms monthly with the developing egg. After ovulation the follicle becomes a corpus luteum which makes progesterone. Either a follicle or a corpus luteum can form a cyst (follicular or corpus luteum cysts). There also are benign (non-cancerous) and rarely (cancerous) cysts which can form in the ovary. If gynecological surgery intervention is needed, the cyst can be removed laparoscopically, a procedure where a surgeon uses small incisions (5-10mm) to insert tiny instruments into a patient’s abdomen and perform the operation.
Ovarian cyst symptoms are often asymptomatic but can include:
- pelvic pain
- pelvic pressure
- abdominal enlargement
- bowel or bladder symptoms
Ovarian cyst treatment:
- Watch and wait; the cyst may go away without treatment
- If gynecological surgery is needed, the cyst can be removed laparoscopically in a procedure called cystectomy or the ovary can be surgically removed (oophorectomy).
Learn more about reproductive gynecological surgery.
Fibroids, also known as uterine leiomyomas, are non-cancerous tumors arising from the myometrium (smooth muscle layer) of the uterus. Other names for these tumors include fibromyomas, fibromas, myofibromas, and myomas.
Fibroids are the most common solid pelvic tumors in women. They can be found in up to 70 percent of women, but only cause symptoms in approximately 25 percent of reproductive age women. They are usually found in women during their 30’s and 40’s, and typically shrink in size after menopause. Fibroids are two to five times more common in black women than white women. The average affected uterus has six to seven fibroids.
Fibroids are classified by their location in the uterus. Subserosal fibroids are located just under the outer layer of the uterus. Intramural fibroids are found within the uterine wall; they can distort the uterine cavity or the outer shape of the uterus. Submucous fibroids are located in the uterine cavity. Ninety-five percent of fibroids are subserosal and intramural, while the remaining five percent are submucosal.
Benign fibroids (uterine leiomyomas) rarely become malignant (leiomyosarcomas). Many researchers and physicians believe this transformation never occurs. Uterine leiomyosarcomas are found in approximately 0.1 percent of women with fibroids and are often associated with large or rapidly growing fibroids. Diagnosis of malignant fibroids can only be made after examining tissue of the uterus.
Learn more about symptoms, diagnosis and fibroid treatments:
Can an Ovarian Cyst Be Cancerous?
Ovarian cysts are fluid-filled sacs that develop in and on the ovaries. They can affect women of all ages and are most often benign. In premenopausal women, ovarian cysts are less likely to be cancerous and more likely the result of normal ovulation and other causes. In postmenopausal women, new growths are somewhat more likely to be cancerous; even so, the vast majority of cysts will be benign.
If ovarian cancer is suspected, the doctor will perform a battery of tests, which includes a pelvic exam, transvaginal ultrasound, and blood tests. If cancer is diagnosed, surgery is commonly performed to remove the tumor. Treatment may also involve chemotherapy, hormone therapy, radiation therapy, and newer targeted therapies.
Understanding Ovarian Cancer Symptoms, Stages, and Treatment
Types of Ovarian Cysts
In most women, cancer is a rare cause of an ovarian cyst. There are numerous other possible explanations, particularly if you are premenopausal. The risk of ovarian cancer tends to increases with age, with most cases occurring after menopause.
Common causes of ovarian cysts in premenopausal women are:
- Ovulation: A “functional cyst” can develop when a follicle does not rupture and release an egg during ovulation. It can also develop as the corpus luteum is being formed after ovulation. These cysts are common and benign, and will typically resolve on their own without treatment.
- Dermoid cysts: Also known as teratomas, these cysts are most commonly seen in women between 20 and 40 and are caused when fetal skin cells become trapped in ovarian tissues. The vast majority are benign.
- Pregnancy: An ovarian cyst can develop in early pregnancy until the placenta is fully formed. In some cases, the benign cyst may persist until later in the pregnancy.
- Severe pelvic infection: Ovarian cysts that develop during a severe pelvic infection are caused by the accumulation of pus in ovarian tissue. A course of antibiotics may be needed to resolve the infection.
- Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder commonly affecting women of reproductive age. It causes the enlargement of the ovaries and the formation of multiple cysts on the outer edges.
- Endometriosis: Endometriosis is a disorder in which the lining of the uterus (endometrium) extends beyond the uterus. It often causes the formation of cysts called endometrioma (also known as “chocolate cysts”).
- Noncancerous growths: These include fibromas comprised of connective tissue and fluid-filled cystadenomas that form on the outside of the ovaries and can become quite large.
- Ovarian cancer: In premenopausal women, fewer than 1% of new growths on or in an ovary will turn out to be cancer.
The picture is slightly different for postmenopausal women. Common causes of ovarian cysts in postmenopausal women include:
- Cystic lesions: Ovarian cysts of less than 1 centimeter (0.4 inches) in size are common in postmenopausal women, the vast majority of which will be benign.
- Intrauterine fluid accumulation: This is a common phenomenon in late postmenopausal women, which can trigger swelling of the ovaries along with the formation of ovarian cysts.
- Ovarian cancer: Around 90% of ovarian cancers occur in women over 45 and 80% occur in women over 50. The vast majority are diagnosed between the ages of 60 to 64.
Despite the increased incidence of ovarian cancer in postmenopausal women, the lifetime risk is still relatively low, affecting around one of 327 women (0.3%) by her 60s and one of 283 women (0.4%) by her 80s.
There are characteristics of an ovarian cyst that make it more likely to be cancerous as well as risk factors that can increase a woman’s odds of a malignancy.
Ovarian cancer is more likely in women with:
- A family history of ovarian, gastrointestinal, or breast cancer, especially first-degree relatives (like parents or siblings) who developed cancer at an early age
- A previous history of breast or gastrointestinal cancer
- A genetic predisposition for ovarian cancer (as indicated by mutations of the BRCA1 and BRCA2 genes) in whom the lifetime risk of ovarian cancer is between 10% and 60%
- An ovarian cyst over 5 centimeters (2 inches) that is irregular in shape and/or has solid areas
- Multiple cysts on both ovaries
- Ascites (an accumulation of fluid in the pelvis or abdomen)
Age also plays a role but does not exclude premenopausal women of whom one in 870 (0.1%) are at risk of cancer.
Abnormal ovarian cysts are commonly referred to as pathologic cysts in lab reports. This does not mean that the cyst is cancerous, but simply that it is unusual in its shape, size, or consistency. Most pathologic cysts are benign.
Symptoms alone cannot predict whether an ovarian cyst is cancerous or benign. Many women with ovarian cancer will experience few if any symptoms, particularly in the early stages. If there are symptoms, they often are non-specific and easily attributed to other less serious conditions.
Women with ovarian cancer often will have vague abdominal symptoms, including:
- Persistent abdominal distension
- A persistent feeling of fullness
- Loss of appetite
- Pelvic or abdominal pain
- An increased need to urinate
Where these symptoms become increasingly relevant is in women over 50. The development of these symptoms in postmenopausal women, along with a significant family history of breast or ovarian cancer, strongly indicates a need for further testing.
Most ovarian cysts are found during an annual pelvic exam. If one is found and ovarian cancer is suspected, the doctor will start the diagnosis by reviewing your family history, medical history, symptoms, and risk factors.
The evaluation may also involve a rectovaginal exam in which a finger is inserted into the vagina and another into the rectum to get a better sense of the size and consistency of the cyst.
Women at high risk of ovarian cancer or with an abnormal pelvic exam will commonly undergo a battery of minimally invasive tests, including:
- Transvaginal ultrasound: This involves the insertion of a wand-like device into the vagina that can image tissues using sound waves. It is the single most effective way of imaging and characterizing ovarian cysts.
- CA-125 test: This blood test measures the level of a protein called CA-125 that is secreted by ovarian cancer cells. While useful in supporting a cancer diagnosis in high-risk women, CA-125 levels can also be increased during menstruation, in women with uterine fibroids, or those with other types of cancers (such as endometrial and peritoneal cancer).
- Magnetic resonance imaging (MRI): This imaging technology uses powerful radio and magnetic waves to create highly detailed images of soft tissue and can help better characterize the structure of an ovarian cyst.
Computed tomography (CT) scans tend to be less sensitive than MRIs and less useful in the initial diagnosis of ovarian cancer. Similarly, blood tests commonly used to diagnose other forms of cancer, like carcinoembryonic antigen (CEA), and cancer antigen 72-4 (CA72-4), are less helpful in women with ovarian cancer.
To confirm a cancer diagnosis, the doctor will perform a biopsy in which a sample of tissue is removed from the cyst for evaluation in the lab. There are several types of biopsy a doctor may use:
- Fine needle aspiration (FNA): This involves the insertion of a 21- to 25-gauge needle through the skin and into the cyst to withdrawal a tiny sample of cells.
- Core needle biopsy: This uses a larger needle to extract a cylinder of tissue about 1/2 inch long and 1/8 inch in diameter.
In some cases, a tissue sample may be performed during a pelvic laparoscopy, a minimally invasive procedure in which a narrow scope is inserted through a tiny incision in the abdomen to view the reproductive organs.
These procedures are not only critical to the diagnosis of ovarian cancer but can also help avoid unnecessary surgery until the malignancy is definitively diagnosed.
In the United States, around 5% and 10% of women will undergo surgical evaluation of an ovarian cyst. Of these tests, 13% to 21% of the investigations will reveal cancer.
Most women diagnosed with ovarian cancer will undergo some form of surgery to remove the tumor. Depending on the type and stage of ovarian cancer involved, other forms of treatments may be recommended, either before or after surgery (or both).
The main goal of ovarian cancer surgery is to remove as much of the tumor as possible, referred to as debulking. This may involve removing nearby tissue, including parts of the colon, small intestine, bladder, liver, spleen, bladder, or pancreas.
Many women with ovarian cancer will undergo a hysterectomy with bilateral salpingo-oophorectomy in which the uterus, both ovaries, and both fallopian tubes are surgically removed.
If cancer is limited to one ovary, the unaffected ovary and fallopian tube may be preserved in women who intend to have children.
Following surgery, aggressive chemotherapy is the mainstay of treatment for most women. This usually involves a combination of drugs comprised of a platinum-based agent like cisplatin or carboplatin and another type of drug called a taxane, which includes Taxol (paclitaxel) and Taxotere (docetaxel).
Other drugs may be added to chemotherapy. Treatment typically is delivered intravenously (into a vein) every three to four weeks for three to six cycles.
Targeted therapies help kill cancer cells but cause minimal harm to normal tissues. These are often incorporated into chemotherapy. Options include:
- Avastin (bevacizumab), which can shrink or slow the growth of a tumor by preventing the formation of new blood cells that nourish them
- PARP inhibitors like Lynparza (olaparib), Rubraca (rucaparib), and Zejula (niraparib) that are typically used for advanced ovarian cancer
Hormonal therapy can treat certain types of ovarian cancer or prevent their recurrence. These include hormones and drugs that block the action of estrogen, a female hormone that can influence the growth of certain cancers. Options include:
- Luteinizing hormone (LH), which lowers estrogen levels in premenopausal women
- Aromatase inhibitors like Femara (letrozole) and Aromasin (exemestane) that lower estrogen levels in postmenopausal women
- Tamoxifen, a drug more commonly used in hormone-sensitive breast cancer but one that may be useful in certain advanced ovarian cancers
Radiation therapy is less commonly used to treat a primary ovarian tumor and is more often employed to treat areas where cancer has metastasized (spread). This typically involves external beam radiation therapy (EBRT) in which a narrow beam of ionizing X-ray radiation is directed at cancerous tissues every three to four days for several weeks.
Brachytherapy, involving the implantation of radioactive seeds into tumors, is rarely used to treat ovarian cancer.
Depending on the type and stage of cancer involved, doctors can generally predict a woman’s long-term outlook (prognosis). This is standardly based on five-year survival rates, which estimate the percentage of women who will live for at least five years following diagnosis.
The prognoses are largely differentiated by whether the tumor is localized, regional (affected nearby tissues), or distant (metastasized).
According to the American Cancer Society, the current five-year survival rate for women with ovarian cancer is:
- Localized: 92%
- Regional: 76%
- Distant: 30%
The outcome of surgery also plays a role in survival rates. Women whose ovarian tumor has been optimally debulked have a better outlook than women in whom tumor tissues remain.
A Word From Verywell
As scary as it may be to hear that you have an ovarian cyst—or, even more specifically, a pathologic ovarian cyst—be aware the majority are benign. Even so, it is important to have any abnormal growth checked out and regularly monitored in the unlikely event it becomes cancerous.
Even if a cyst turns out to be malignant, early diagnosis almost invariably confers to simpler treatments and better outcomes. Ever-improving therapies are likely to extend survival times in the coming years, even among women with advanced ovarian cancer.
Ovarian cysts | Target Ovarian Cancer
Ovarian cysts are fluid-filled pockets called sacs that can form in the ovaries. They are very common and can affect women of any age, although they are more frequent in women of childbearing age because they are linked to ovulation. Often a cyst develops and disappears without the woman even knowing that she had one. Cysts in pre-menopausal women can produce symptoms similar to those for ovarian cancer but are not known to increase the risk of ovarian cancer.
Types of ovarian cyst
The most common type of cyst is called a functional cyst. Other types of cysts include:
- polycystic ovaries (numerous cysts sitting under the surface of the ovaries)
- cysts caused by endometriosis, also known as endometriomas – this is a condition where the lining of the womb (endometrium) grows outside the body of the womb
- cystenadomas and dermoid cysts (containing a mix of different tissues).
Managing functional cysts
The approach to managing functional cysts will depend on a number of factors, mainly your age, symptoms and your medical and family history. If you’re experiencing symptoms because of a cyst, your GP may recommend a CA125 blood test and transvaginal ultrasound (TVU). The result of these will be combined with other factors, including whether you’ve been through the menopause yet, to calculate the likelihood/chance (risk) of the cyst being malignant (cancerous).
Many cysts will disappear on their own. Others that are considered low-risk will be monitored every three to six months by further ultrasound scans. Surgery is only considered if the cyst has the potential for being cancerous, or because it’s large and could cause complications or uncomfortable symptoms.
A tumour (also known as a neoplasm) is any abnormal mass of tissue (collection of cells). Like a cyst, a tumour can form in any part of the body. A tumour can be benign (non-cancerous), malignant (cancerous) or borderline (between malignant and benign).
Benign (non-cancerous) tumours may cause symptoms both in most cases they do not come back after surgical removal (having an operation.) Cells in benign tumours do not spread to other parts of the body.
Malignant (cancerous) tumours are made up of cells that grow out of control. Cells in these tumours can invade nearby tissues and spread to other parts of the body. Sometimes cells move away from the original (primary) cancer site and spread to other organs and areas through the bloodstream or lymphatic vessels (tiny vessels similar to blood vessels passing clear fluid towards the heart) where they can continue to grow and form another tumour at that site. This is known as metastatic or secondary cancer. Metastases keep the name of the original cancer location, so ovarian cancer that has spread to the liver is still called ovarian cancer.
Borderline tumours are rare types of growths, and although the cells look abnormal, they rarely have the tendency to grow out of control.
To determine whether a cyst or tumour is benign, malignant or borderline, a sample of the affected tissue – or, in some cases, the entire suspicious lump – is removed and studied under a microscope. This is known as a biopsy. In most cases, this can be done using a needle under a CT scan or ultrasound scan with local anaesthesia, but occasionally a tummy/abdomen cut (laparotomy) or keyhole operation (laparoscopy) is necessary under general anaesthesia.
This information is reviewed regularly and is in line with accepted national and international guidelines. All of our publications undergo an expert peer review and are reviewed by women with ovarian cancer to ensure that we provide accurate and high-quality information. To find out more take a look at our information standards.
Last reviewed: June 2018
Next review: May 2021
Ovarian Cysts in Children and Teens
- An ovarian cyst is an abnormal fluid-filled sac on the inside of the female reproductive organ.
- Most ovarian cysts are not serious and cause no symptoms. Many cysts will go away on their own.
- In rare cases, a doctor may drain or remove the cyst with surgery if it poses significant risk to the patient’s health.
What is an ovarian cyst?
An ovarian cyst is an abnormal fluid-filled pocket that develops on the inside of a girl’s ovaries. The ovaries are the female reproductive organ and are found in the lower abdomen. The ovaries release an egg during the ovulation phase of each menstrual cycle (period). Cysts in the ovaries are relatively common and can affect girls and women of all ages.
An ovarian cyst can occur in one or both ovaries. The cysts can occur as single sacs or in clusters, and are sometimes filled with other substances like blood in addition to fluid. They can be many different sizes and occur in different locations within the ovary. Most ovarian cysts in children and young women are benign (non-cancerous), but can develop into cancer in rare cases. In severe cases where the cyst is very large and heavy, its unbalanced weight can cause the ovary to twist in an abnormal way. The twisting cuts off blood flow to the ovary and can damage the organ. This rare complication is called ovarian torsion.
What causes ovarian cysts in children and teens?
Many ovarian cysts are caused by normal body processes. Cysts can develop at different stages in the menstrual cycle in response to changing levels of sex hormones.
Ovarian cyst symptoms in children and teens
Small ovarian cysts that go away on their own often cause no symptoms. If the cyst is larger or more serious, it may cause symptoms such as
- Sharp pain in the pelvic (lower abdominal) area during the ovulation phase of the menstrual cycle
- Irregular period
- Pelvic pain that doesn’t go away
- Bloating, swelling, or a feeling of fullness in the lower abdomen
- A need to urinate that doesn’t go away. This can happen if the cyst is large enough to push against the other internal organs and put pressure on the bladder
If a girl develops ovarian torsion, her symptoms will be much more immediate and severe. Symptoms may include
- Severe pelvic pain
- Nausea and vomiting
- Loss of consciousness (passing out)
Diagnosing ovarian cysts in children and teens
Because many ovarian cysts cause no symptoms, they are often diagnosed incidentally (by chance) during tests for other conditions. If a child has symptoms of an ovarian cyst, doctors can use multiple tests to make a diagnosis. These include
- Pelvic ultrasound, which allows the doctor to visualize the cyst. The ultrasound creates an image of the child’s lower abdomen so that the doctor can see the size and location of the cyst.
- Blood testing to check the child’s hormone levels.
Treatment for ovarian cysts in children and teens
Treatment for an ovarian cyst depends on the cyst’s size and severity.
- In cases where the cyst is small and causes few or no symptoms, doctors may monitor the cyst with follow-up appointments. Every few months, a doctor will take an image of the ovaries using an ultrasound to make sure that the cyst is not growing. This is repeated until the cyst goes away on its own.
- If the cyst does not go away, doctors may surgically remove the abnormal mass of cells. This is only necessary in a small number of cases.
- If the cyst is particularly large, doctors may drain the fluid out of it or remove it to prevent ovarian torsion.
- A doctor may prescribe hormonal medication like birth control to prevent more cysts from forming.
Ovarian Cysts Don’t Have to Be a Pain
Ovarian cysts may cause you pain. Fortunately, most women can get relief of their pain from persistent ovarian cysts with same day outpatient surgery. There are different types of ovarian cysts with varying symptoms and treatment options.
Devin Namaky MD, with TriHealth’s Advanced Gynecologic Surgery reviews the types of ovarian cysts, symptoms you may have, treatment options, what happens when cysts rupture, and how you might prevent ovarian cysts.
What Is an Ovarian Cyst?
Ovarian cysts are fluid-filled sacs that grow on the ovary. All women who ovulate grow “cysts” each month on their ovaries. These “cysts” are either follicular cysts or corpus luteal cysts, and usually go away on their own without treatment.
Most ovarian cysts are benign and not cancerous. Ovarian dermoid tumors, endometriosis and cystadenomas may also present as ovarian cysts. These are usually found during a pelvic ultrasound and can sometimes be found on CT or MRI scans. Rarely, ovarian cysts might be ovarian cancer.
What Is a Dermoid Cyst?
Ovarian dermoid cysts are usually not cancerous. Dermoid cysts may contain body parts, such as fat, skin, teeth or even hair. They can grow very large and are removed surgically.
Can an Ovarian Cyst Rupture?
Yes, ovarian cysts can rupture, causing you sudden sharp pain. You may need surgery if they don’t go away on their own. Ovarian cyst rupture can cause you to have internal bleeding, which can be a surgical emergency.
Can Ovarian Cysts Cause Pain?
You may have pelvic or ovarian pain. Ovarian rupture and ovarian torsion can both cause pain. Ovarian torsion is an emergency where the ovary and cyst twist on themselves. If ovarian torsion isn’t treated, your ovary can die. Thankfully, most ovarian pain isn’t from cyst rupture or ovarian torsion. Ovarian cysts need to be removed with surgery if you have persistent pain.
Ovarian Cyst Surgery
What Is Ovarian Cystectomy?
Ovarian cystectomy is surgery to remove ovarian cysts from your ovary, leaving the rest of the healthy ovary behind in your body. Most ovarian cysts that aren’t cancer can be removed this way.
What Is Oophorectomy?
Oophorectomy is removal of your entire ovary and ovarian cyst together. This is rarely necessary for non-cancerous cysts. This may be needed if you have no normal ovary left, or if you have high risk of the ovarian cyst being cancer. Both of these situations are rare.
You may be able to avoid surgery. Persistent non-cancerous ovarian cysts can be followed with ultrasound and watchful waiting if they aren’t causing you pain.
Can Ovarian Cysts Be Cancer?
Ovarian cysts can sometimes be cancer. About one in every 70 women develop ovarian cancer in their lifetime. This would usually be in older patients over the age of 50. In order to find out if an ovarian cyst is cancerous, you need to have it removed with surgery. Thankfully, most patients with ovarian cysts don’t have ovarian cancer.
Can Ovarian Cysts Be Prevented?
Since ovarian cysts are often caused by your normal menstrual cycle, many experts believe your cysts can be prevented using hormonal medications. Strong evidence is lacking to support hormonal medication for preventing ovarian cysts. However, some may benefit from this treatment, and it would be reasonable to discuss this treatment with your physician.
Avoid Traditional Open Surgery
Most ovarian cysts removed with surgery do not need laparotomy or traditional open surgery. Most patients go home the same day with outpatient surgery and can be back to work within two weeks using minimally-invasive laparoscopy.
Dr. Namaky is trained in surgical techniques to remove large ovarian cysts through small incisions. The size of your cyst doesn’t matter. Even the largest ovarian cysts can be removed minimally-invasively, without laparotomy.
If you have received a recommendation to have open surgery for a non-cancerous ovarian cyst, you may benefit from having a second opinion to see if you can have minimally invasive surgery.
Do you need relief of your cyst pain? Would you like a second opinion to know if you could have an outpatient same-day surgery instead of traditional open surgery? Call 513-862-1888 now for an appointment with Dr. Namaky.
July 03, 2019
Ovarian Cysts: Causes, Symptoms & Treatment
Ovarian cysts are sacs of fluid that can grow on the ovaries. They are very common; most women will get them at least once some time in their lives, according to the Mayo Clinic. For the most part, ovarian cysts are not life threatening or even bothersome. Some women do experience more advanced cases that require medical treatment.
According to the U.S. National Library of Medicine (NLM), women that are between puberty and menopause are most likely to develop ovarian cysts. There are several kinds of cysts that can form on the ovaries during this time in life.
The most common is a functional cyst. The ovaries grow structures called follicles, where immature eggs develop. If the follicle doesn’t open up and release the egg, it fills with fluid and causes a cyst. This is one type of functional cyst called a follicular cyst. If the cysts forms after the egg is released it is called a corpus luteum cyst.
Polycystic ovary syndrome (PCOS) is when the body doesn’t produce enough hormones for the follicle to release the egg, causing follicular cysts. PCOS disrupts the normal production of hormones, which can cause various problems.
Other cysts develop from tissue and cells. Some are created with ovarian tissue filled with a watery liquid or a mucous material. These types of cysts are called cystadenomas. Dermoid cysts are ovarian cysts that can contain hair, skin or teeth. These unusual additions are caused by cells that produce human eggs, according to the Mayo Clinic. Endometriomas are cysts caused by uterine endometrial cells growing outside the uterus and attaching to the ovary to form a growth.
Sometimes cysts can be caused by outside factors. For example, fertility drugs can cause multiple, large cysts on the ovaries. This condition is called ovarian hyperstimulation syndrome.
When a cyst becomes cancerous it is called ovarian cancer. One in 75 women will develop ovarian cancer, and about 14,240 women will die from ovarian cancer in 2016, according to the American Cancer Society.
Many women with ovarian cysts don’t experience any symptoms. This is particularly true with functional cysts. Symptoms usually occur when something goes wrong. For example, a cyst may grow larger, start bleeding, break open, twist the fallopian tube or interfere with the blood supply to the ovary, according to NLM. Some symptoms are also caused when a cyst is bumped during sexual intercourse.
Possible symptoms can include a sensation of pelvic fullness because a cyst is pressing on the bladder, pelvic tenderness or pain in the right or left side of the lower abdomen that can radiate to the back and down to the legs, pain while defecating, breast tenderness, changes in the menstrual cycle, such as spotting or bleeding at times other than when menses is expected and difficulty emptying the bladder.
Women experiencing ovarian cysts may also have problems eating. Getting full quickly when eating, loss of appetite and losing weight without trying most days for at least two weeks may be a sign of a cyst, according to NLM.
It is important to be aware of the symptoms of ovarian cysts because some symptoms are an indication that immediate medical attention is needed. “If you experience sudden, severe abdominal or pelvic pain, nausea or vomiting, or a fever, seek immediate medical attention, as this may be a sign of a more serious problem,” Dr. Leigh Matlaga, an OB/GYN at MedStar Franklin Square Medical Center.
Detection & treatment
Most cysts clear up on their own without the need for treatment in eight to 12 weeks, according to NLM. “However,” said Dr. Antonella Lavelanet, an obstetrician at Boston Medical Center, “cysts that grow larger than 5 centimeters are at greater risk for torsion (twisting around the Fallopian tube). Torsion is a gynecologic emergency. Women with ovarian torsion present with sudden onset of abdominal pain, often associated with nausea and possibly vomiting and low-grade fever.”
Early monitoring is key to finding ovarian cysts before they become a problem. “All women should visit their gynecologist regularly,” said Matlaga. “Routine pelvic exams can detect ovarian cysts, or any other changes in your ovaries, as early as possible. It is important to pay attention to your body and report any changes in your monthly cycle to your doctor.”
Doctors will often check for cysts using ultrasound, but other imaging devices, such as CT scans or MRI may also be used. Blood tests may also be performed to search for changes in hormone levels, signs of pregnancy and possible cancer. Once a cyst is confirmed, larger, cancerous or persistent cysts may be removed surgically. If the woman is near menopause the cysts may also be removed.
Some women are more prone to developing cysts. In these cases, a medical professional will often prescribe birth control that contains estrogen to help reduce the risk of developing certain types of functional cysts that occur after ovulation.
Women are often worried that cysts may affect their fertility. In general, fertility is not affected by functional cysts. “However, if cysts become too large and need to be removed surgically, there is always the risk that the ovarian tissue will be compromised or the ovary will be removed in its entirety,” said Lavelanet. As long as the other ovary is intact and functioning properly, a woman is usually able to go on to have children.
Ovarian cyst: diagnosis and treatment of cysts in girls and women in Odessa
Why contact us?
Odrex Medical House is a multidisciplinary center with the necessary resources for the diagnosis and treatment of gynecological pathologies:
- A staff of experienced doctors – practical experience of obstetricians-gynecologists for more than 5 years;
- Clinical laboratory for performing a set of necessary analyzes;
- Possibility of outpatient and inpatient treatment, from conservative treatment to surgery.If an operation is needed to remove an ovarian cyst, it is performed by a low-traumatic method of laparoscopy;
- Treatment of the disease on a turnkey basis – from the initial treatment to the subsequent regular examination by specialists.
Diagnosis of ovarian cysts in Odrex
Cyst is detected during gynecological examination and ultrasound of the pelvic organs. These studies allow us to assess its location and size, but they are not enough to determine the type and nature of the neoplasm.
Therefore, to clarify the diagnosis, the doctor may prescribe the following additional studies:
- MRI of the pelvic organs – a high-precision informative method for detecting malignant neoplasms at an early stage;
- Blood test from a vein for gynecological tumor markers CA125 and HE4 – then the ROMA index is calculated using a special formula, which allows you to assess the risk of developing epithelial ovarian cancer. This type of cancer is diagnosed in 90% of cases of ovarian malignant neoplasms.
If an ovarian cyst bothers a woman, then the symptoms are indistinct, typical for most diseases of the abdominal organs – abdominal pain, nausea, heartburn, vomiting, pain during sex or urination, profuse, frequent or scanty menstruation, delayed menstruation. To exclude or confirm other diagnoses, in some cases, the following are prescribed:
- Colonoscopy – examination of the inner surface of the colon for malignant neoplasms;
- FGDS (fibrogastroduodenoscopy) – a high-precision method for examining the esophagus, stomach and upper part of the duodenum;
- Colposcopy – examination of the vagina and cervix;
- Histological examination of the uterine cavity.
Depending on the diagnosis, the doctor selects the methods of ovarian cyst treatment. The tactics can be expectant, conservative, or surgical.
Ovarian cyst treatment in Odrex
A functional ovarian cyst, follicular or luteal, is diagnosed in about 90% of visits. Such a cyst is formed due to hormonal disruption. Normally, a mature follicle bursts and an egg comes out of it.
If the egg remains inside, the follicle is absorbed.With hormonal disorders, the mature follicle continues to increase in size, and a follicular cyst develops.
A luteal cyst forms at the site of the corpus luteum. Normally, a burst follicle transforms into a corpus luteum, which subsequently also dissolves. With pathologies, this does not happen, and the corpus luteum turns into a cystic ovarian formation.
When a cyst is up to 1 cm in size, a wait-and-see tactic is used, in which the size and nature of the formation is monitored every 1-3 months.With an increase in the size or initial detection of a cyst 2-5 cm in size, conservative treatment is prescribed. Oral contraceptives are used to correct hormonal levels. Non-hormonal treatment is also possible, when proteolytic enzymes and hormone-like substances are prescribed for resorption of the formation. The effectiveness of the course of treatment is monitored using ultrasound.
If conservative treatment fails, or the size of the cyst exceeds 10-15 cm, or the detected cyst is of a presumably malignant nature, laparoscopy is recommended – removal of the ovarian cyst.Unlike traditional surgery, three 5 mm micro-incisions are made for the operation. Through one, a laparoscope is inserted into the abdominal cavity – a special optical device that allows the surgeon to assess the location and nature of the pathology. The cyst is removed through other micro-incisions. At the same time, the ovarian tissue is preserved as much as possible.
Laparoscopic treatment of a cyst significantly reduces the risk of postoperative complications and the time of complete rehabilitation of a woman. You will spend 1 day in the Odrex Surgical Department (in traditional surgery, the hospital stay is 6-7 days).It will take 2-3 times less time to heal wounds – 5-7 days versus 2-3 weeks.
Question – answer
Do girls have ovarian cysts?
Yes, ovarian cysts can be found in girls and women of all ages, although it mostly develops in women of reproductive age. In girls under 15 years of age, a dermoid cyst is often diagnosed. The reason for its development is genetic malfunctions, and it can only be treated surgically.
What if an ovarian cyst is found during menopause?
During menopause, the cyst does not exhibit hormonal activity, so its regression is usually impossible.If an ovarian cyst is detected in old age, the operation is recommended when the size of the formation is more than 3 cm.
Why is a cyst dangerous?
The most serious danger to life is represented by three complications – rupture of the ovarian cyst, its twisting and the degeneration of the formation into a malignant tumor. When the cyst ruptures in 90% of cases, it is possible to preserve the ovary. When the cyst is twisted, the ovary can be preserved, but an operation is indispensable. The worst prognosis for ovarian cancer is that after such a diagnosis, 10-30% of women survive until the end of the first year.Also, ovarian cysts are a common cause of infertility.
Is re-development of an ovarian cyst possible?
Yes, it is possible. The risk group also includes women with hormonal disorders due to abortion, inflammatory diseases of the female genital organs, endocrine pathologies (diabetes mellitus, thyroid disease, obesity). Therefore, regular visits to the gynecologist and following the doctor’s prescriptions will help to avoid serious complications.
How to minimize possible complications of ovarian cysts?
For the prevention of complications, Odrex Medical House offers participation in the Universal Check-Up program.Every year you will undergo a comprehensive medical examination, including examination by a gynecologist. Visiting doctors and analyzing the key indicators of the body allow you to identify ovarian pathology at an early stage and start timely treatment. Be healthy!
Ovarian cyst is a widespread disease in women of childbearing age. At the same time, 30% of cases of cyst formation are diagnosed in patients with a regular menstrual cycle and 50% – with a disturbed one.During menopause, the disease can occur in 6% of women.
By their nature, cysts are divided into functional and organic. The former are temporary in nature and are formed due to a slight disruption of the ovary. A functional cyst is usually treated with oral hormonal drugs and will self-destruct after one to two months. But there are also cysts that do not disappear for more than two months and require surgical intervention. They are called organic.
Follicular .The follicular cyst cavity has thin walls with a smooth surface, with a diameter of two to seven centimeters. Sometimes several follicular cysts can form in a cut, but they are always single-chambered, without partitions.
Cyst of the corpus luteum. Functional cyst. The corpus luteum cyst has thickened walls and can be from two to seven centimeters in diameter. The inner surface of the cyst is often yellow, the contents are light, and with hemorrhages, bloody.
Hemorrhagic. It is a consequence of hemorrhage inside the formed follicular cyst or cyst of the corpus luteum.
Endometrioid. Formed when tissues of the lining of the inner layer of the uterine wall grow in the ovaries. An endometrioid cyst is often filled with dark contents, blood, and its diameter ranges from two to several tens of centimeters.
Dermoid. Represents the parts of embryonic germ sheets enclosed in a mucus-like mass, derivatives of connective tissue (fat, cartilage, skin). The dermoid cyst usually does not reach large sizes, it grows slowly.
Mucinous. Benign epithelial tumor. The cavity of this cyst has an uneven surface and is filled with mucin – a mucus-like fluid that is a secret of the epithelium. A mucinous cyst can be quite large and have several chambers.
Serous. Benign epithelial tumor. The surface of the capsule is lined with serous epithelium. Contains a transparent liquid of light straw color inside.
Epithelial tumors. Developed from the epithelial components of the ovary. They can be benign, borderline, and malignant.
Germ cell tumors. They account for less than 5% of all neoplasms in the ovaries.Moreover, they are characterized by the most turbulent current. They are often quite large (more than fifteen centimeters).
There are quite a few reasons for the development of an ovarian cyst:
- hormonal and endocrine system disorders
- early menstruation
- artificial termination of pregnancy, including abortion
- thyroid dysfunction
- inflammatory diseases and genital infections
An ovarian cyst can have various complications:
- Some types of cysts, with long-term existence, can develop into malignant ones.It should be remembered that only histological examination can be an accurate method for diagnosing the nature of the cyst.
- Torsion of the cyst leg, which can be accompanied by severe pain syndrome, rupture of the cyst, which may result in the development of peritonitis
The cyst is diagnosed by the following methods:
- Gynecological examination. Allows you to determine the pain in the lower abdomen and an increase in the appendages.
- ultrasound. The most informative method, as it allows not only to determine the presence of a cyst, but also to observe its development.
- Laparoscopy. Not only an almost 100% method of diagnosing a cyst, but also a method of its treatment.
- Computed tomography or magnetic resonance imaging. These methods are used to clarify the benign quality of the cyst, its location, size, structure, contours and other indicators necessary for the operation.
The choice of treatment for a cyst depends on the nature of the cyst, its type and the development of possible complications. The most common functional cysts are usually treated with oral hormonal drugs. These cysts can take anywhere from two to three months to heal, depending on the size of the lesion. In this case, the dynamics of treatment is monitored using ultrasound. With the ineffectiveness of drug treatment, surgical intervention is recommended.
Surgical method as the main one is more often used for the treatment of complex cysts of an organic nature. Modern technologies imply in such cases laparoscopic intervention, which allows minimizing damage to healthy tissues, reducing complications from surgery to zero and minimizing hospitalization times. In any case, during the operation, doctors will try, if possible, to preserve the patient’s ovary and reproductive capabilities.
In the department of X-ray surgical methods of diagnosis and treatment of the OKDC, the following types of operations are performed for cysts and benign tumors of the uterine appendages:
- laparoscopic enucleation of ovarian cysts
- laparoscopic ovarian resection (removal of part of an organ)
- laparoscopic oophorectomy, adnexectomy (removal of the ovary, uterine appendages)
During surgery on the uterine appendages (ovary and fallopian tube), an urgent histological examination is required, which allows you to accurately establish the nature of the tumor: benign, borderline, or malignant.This helps to avoid repeated surgical interventions when detecting borderline and malignant tumors of the uterine appendages. If they are found in the department of RHMDL, radical operations are performed, including high-tech ones: laparoscopic extirpation of the uterus with appendages, omentectomy (removal of the uterus with appendages, greater omentum).
90,000 Benign tumors and tumor-like formations of the ovaries
Table of Contents
Benign ovarian tumors (DOJ) is one of the most pressing problems of modern gynecology.Tumors and tumor-like formations of the ovaries account for up to 14% of tumors of the female genital organs, of which 80% are represented by cystic formations of a benign nature – ovarian cysts.
An ovarian cyst is a hollow, rounded formation filled with fluid. The sizes of these formations can reach from a few centimeters to 15-20 cm in diameter. Most ovarian cysts do not pose any danger to a woman’s health, do not require any treatment and go away on their own within several menstrual cycles, however, there is a risk of complications and malignancy (malignancy) of the ovarian formations, which requires a differential approach from the doctor to the treatment and observation of ovarian formations.Unfortunately, ovarian cancer ranks first in late detection among tumors of the female reproductive system, which makes the most significant contribution to mortality rates from genital cancer.
There are various risk factors for ovarian tumors:
- Early Menarche
- Late menopause
- Reproductive disorders (infertility, irregular menstrual cycle, anovulation)
- High-calorie diet high in saturated fatty acids
- Genetic predisposition (cases of familial cancer)
An ovarian cyst can be asymptomatic, or have a number of symptoms that determine the clinical picture of this pathology.The main symptoms are:
- Periodic or persistent pulling pain, however, the pain can have the character of severe sharp abdominal pains, arising acutely, which is most often a manifestation of a complication of ovarian cysts – rupture, torsion, cyst suppuration – an emergency condition requiring urgent surgical treatment
- Menstrual irregularities
- Malignancy (degeneration into a malignant tumor)
In order to identify an ovarian cyst and determine further tactics, it is necessary to carry out a number of diagnostic measures:
- Careful history taking
- Gynecological examination (detection of a tumor and determination of its size, consistency, mobility, sensitivity, location in relation to the pelvic organs, the nature of the tumor surface)
- Rectovaginal examination (to exclude tumor invasion into other organs of the small pelvis)
- Ultrasound examination: with a filled bladder, transvaginal echography, with color Doppler (differential diagnosis of benign and malignant tumors)
- Puncture of cystic formations followed by cytological examination of the resulting fluid
- Determination of tumor-associated markers, in particular CA-125; CA-19.9; CA-72.4; Roma index
- Computed and / or magnetic resonance imaging
- X-ray of the gastrointestinal tract (to exclude metastatic lesions of the ovaries (irrigoscopy, sigmoidoscopy, colonoscopy)
- Cytoscopy and excretory urography (according to indications)
- Diagnostic laparoscopy
Treatment of ovarian tumors
Treatment for ovarian tumors depends on the age, nature of the tumor and the reproductive plans of the woman.In the reproductive age, during the operation, it is necessary to strive for the preservation of ovarian tissue and the prevention of ovarian cancer. In perimenopause, the main task is radical treatment to avoid relapse and maintain a high quality of life.
Functional cysts are the most common type of ovarian cyst and usually do not require any treatment. Cysts larger than 10 cm are subject to surgical removal, or cysts that do not go away on their own within 3 menstrual cycles.
In case of complications of an ovarian cyst (rupture, twisting, compression of adjacent organs), it is also necessary to perform an operation. Currently, most operations for ovarian cysts are performed by the laparoscopic method, which significantly reduces the risk of adhesions, speeds up rehabilitation, and improves reproductive results.
Prevention of ovarian tumors
The main preventive measure for the early detection of ovarian cysts is regular gynecological examinations, supplemented by ultrasound examination of the pelvic organs using a vaginal probe and color Doppler mapping.A study of tumor markers, especially CA 125, is being carried out, and recently – the calculation of the Roma index (calculation of the likelihood of developing epithelial ovarian cancer), which is especially important in women with a family history of ovarian tumors.
The prophylactic role of long-term use of COCs (oral contraceptives) has been proven; it has also been proven that ovarian tumors are diagnosed much less often in women with realized reproductive function. A low-calorie diet high in plant fiber, vitamin A and selenium is essential.
Medsi Clinic St. Petersburg – for the benefit of your health!
90,055 90,000 Borderline tumors and their treatment
Benign, malignant and borderline tumors are found in the ovaries. Benign tumors usually do not transform into malignant ones, but they can cause pain and torsion of the ovarian vessels, and in some cases they can proceed without symptoms at all. Malignant tumors are often aggressive, rapidly progressing and metastasized.They require complex treatment – radical surgery and chemotherapy before and / or after surgery.
Borderline tumors among ovarian neoplasms occupy a special place – the name itself well describes the essence of this disease, they have some features of both malignant and benign tumors. Technically, they are not benign and are accompanied by frequent relapses when choosing an organ-preserving treatment, but they are also not malignant and do not require chemotherapy.Borderline tumors are insidious in that they affect more often young women 30–45 years old, who very often have not yet had time to realize their reproductive function.
Borderline ovarian tumors: symptoms
Often, with borderline tumors, specific symptoms are not observed, which complicates their diagnosis. As a rule, they are detected for the first time according to the histology of a removed cyst, when a gynecological surgeon performs an operation for presumably benign ovarian cysts. If the cyst looks suspicious of malignancy, an express histology is always required during the operation, and when the diagnosis is confirmed, a gynecologist is called to the operating room to perform laparoscopic removal of the omentum and additional biopsies.This tactic helps patients avoid a second surgery and re-anesthesia.
Facts and risks
Approximately 10% of borderline ovarian tumors develop into malignant neoplasms with recurrence. This means that the tumor, which, according to the histological study, was previously borderline, returns after a while, but already as malignant. Unfortunately, even the most modern diagnostic technologies (such as ultrasound, CT, MRI, tumor markers) do not allow a borderline tumor to be diagnosed with 100% accuracy before surgery.Externally, borderline neoplasms can appear as benign or malignant, and only intraoperative or postoperative histology can accurately determine the diagnosis. Also, there are no specific symptoms for which a doctor could diagnose an ovarian tumor, unless the tumors become very large and do not put pressure on neighboring organs, which is extremely rare in the case of borderline tumors.
Surgical treatment in EMC
Realizing that every tenth patient will die from a recurrence of a borderline tumor, doctors today are much more wary of each case of this disease.We perform organ-preserving surgeries for young women so that the patients are ready for childbirth in the future and maintain their hormonal function. Such methods of treatment do not worsen the prognosis of the disease for a woman’s life, but are associated with a higher risk of relapse – up to 40-50%. Such relapses require repeated and, often, not a single operation.
However, in the overwhelming majority of cases, even if it is necessary to expand the scope of the operation, such interventions should be performed laparoscopically – this is the world standard that we follow at the European Medical Center.Unfortunately, this cannot be said about the majority of oncological institutions in Russia, where laparoscopy is not performed in such cases. Abdominal operations for borderline tumors are the exception rather than the rule.
If the patient has not yet had a pregnancy and childbirth, we at EMC recommend organ-preserving surgeries, and even if a relapse occurs and we are forced to perform repeated laparoscopic surgeries, it is usually possible to save a part of the ovary for subsequent stimulation of ovulation by a reproductive physician in the IVF protocol.We receive eggs for cryopreservation (freezing) and their further fertilization before the possible onset of the next (second, third, etc.) relapse, which may already require the complete removal of the remaining ovary. Thus, the uterus with this disease in young women is almost never removed, even with common forms of borderline tumors. Such patients, within a few months after the operation, can become pregnant and independently bear their biologically natural child.
Many clinics in Russia offer chemotherapy as part of the treatment of borderline ovarian tumors after surgery. This is fundamentally wrong because these lesions do not actually respond to chemotherapy. All that women receive from such treatment is the toxic effects of therapy in the form of neuropathy (numbness of the hands, feet, hearing loss, etc.) and bone marrow damage. It has also been proven that the likelihood of relapses from chemotherapy does not decrease, so all that is required within the framework of correct treatment is to conduct a histological diagnosis during an operation with a suspicious formation on the ovary, and if it shows that we have a borderline tumor, perform the necessary manipulations laparoscopically. to determine the stage and exclude the spread of the tumor outside the ovary.
At EMC, we do not offer chemotherapy to our patients with borderline tumors and we do not perform radical surgeries for borderline tumors, when both ovaries are removed together with the appendages and the uterus, when it comes to young women with still functioning ovaries.
History of a patient diagnosed with Borderline ovarian tumors at the age of 31.
Laparoscopy of the ovary – the price of laparoscopic operations in the treatment of ovaries in Moscow
The ovaries are the main glands of the female body, the normal functioning of which ensures adequate development during puberty, the functioning of the female body in adulthood and the bearing of a healthy child.Almost all gynecological diseases are associated with all kinds of deviations from the norm in the ovaries. The pathology of these organs requires the indispensable observation of a doctor and timely treatment. In the network of clinics “Mother and Child” women are provided with extensive and high-quality care for a variety of diseases of the ovaries.
The main method of both diagnostics and surgical treatment of diseases of the female genital glands today is laparoscopic. It is laparoscopic ovarian surgery that is the most effective, safe and low-traumatic operation for the following problems:
- Polycystic ovary
- Endometriosis of internal genital organs, namely ovarian endometriosis.
- Torsion of the appendages.
- Acute and chronic infectious and inflammatory diseases.
- Adhesion process in the abdominal cavity.
- Benign neoplasms of the female reproductive glands.
Laparoscopy for ovarian cysts
Laparoscopic removal of ovarian cysts is one of the most widely used operations in gynecology. At the same time, for a woman, surgical intervention is as gentle as possible.On the one hand, the duration of laparoscopy does not exceed 30 minutes, on the other hand, blood loss in such treatment conditions is minimal.
The rehabilitation period takes very little time. Within a few hours, the patient can engage in self-care, and the next day, she is able to go home. Literally 10-14 days after the laparoscopic intervention, the woman is able to return to her usual lifestyle, go to work.
Indications for ovarian laparoscopy
Like any other operation, laparoscopy should have its own indications and contraindications.In some cases, its implementation is meaningless or can even harm the patient, while in others it can significantly facilitate the operation and save from unnecessary trauma.
- Diagnostics. With the help of endoscopy, both diagnostics and treatment are possible. Diagnostics is used for non-informative or low informativeness of other research methods (ultrasound).
- Polycystic ovary syndrome. Treatment of polycystic ovaries with laparoscopy is indicated in case of ineffectiveness of the drug therapy used.Drilling is most commonly performed to facilitate ovulation.
- Neoplasms. Laparoscopy allows not only to visually assess the state of the tumor, the nature of its growth, but also to take a biopsy to determine the presence of malignant cells. If the tumor is benign and not large in size, it can be removed without laparotomy surgery.
- Cysts. An opening and removal of the ovarian cyst is performed during laparoscopy.
- Adhesion process in the small pelvis. The presence of adhesions very often becomes the cause of infertility, menstrual irregularities. Their dissection can significantly improve the quality of a woman’s life and restore reproductive function.
- Torsion of the uterine appendages. The appendages of the uterus during laparoscopy are set in a normal position, and if they are necrosis or the presence of a cyst, the formation is resected.
- Endometriosis. In some cases, this disease affects the ovaries, which leads not only to the development of a number of symptoms, but also can significantly interfere with the normal functioning of the female reproductive glands.
- Purulent-inflammatory processes. The endoscopic technique allows you to remove the ovary if antibiotic therapy is ineffective.
Contraindications to ovarian laparoscopy
In some cases, the use of the technique of laparoscopic surgery is contraindicated, since it may have no effect or even lead to serious complications.
- Malignant neoplasms of any localization, including the ovary.Surgical treatment of malignant tumors should be carried out with the removal of large parts of the organ and regional lymph nodes. Laparoscopy is unable to provide such a volume of surgery.
- Neoplasms and cysts more than 10 cm in diameter. Removal of such neoplasms endoscopically is impossible due to their large size.
- Massive internal bleeding. They are an indication for an urgent laparotomy operation due to a threat to life.
- Massive adhesive process. Excessive adhesions interfere with the normal view of the endoscope and the manipulation of special instruments.
- Excessive amount of gas in the intestines. Interferes with the normal functioning of the endoscopic surgeon.
- Peritonitis. It is a strict indication for laparotomy due to the threat to the patient’s life.
- Heart or respiratory failure of a high degree.Introduction to anesthesia and, moreover, the surgery itself can be fatal.
- Myocardial infarction, stroke for up to 6 months or causing serious complications. During the intervention, there is a high risk of a sharp deterioration in the patient’s condition.
- Presence of an acute or chronic infectious process. Any surgical intervention is contraindicated due to the risk of spreading the infection.
- Violation of the blood coagulation function.With a high degree of probability, bleeding during surgery can lead to the development of shock or death.
- Obesity III – IV degree. Laparoscopy is impossible due to the fact that the endoscopic instruments will not be able to function normally due to the excess amount of adipose tissue.
Preparation for operation
In preparation for laparoscopic ovarian surgery, as with any other surgical intervention, it is necessary to conduct a number of studies and measures aimed at improving the prognosis of treatment.
- General analysis of blood and urine. Allows you to identify deviations from the norm and assume the nature of the existing pathological process.
- Biochemical blood test. Allows you to evaluate the performance of individual organs and systems in order to take the necessary measures and prevent possible complications.
- Coagulogram. Allows you to assess the blood coagulation function and prevent the development of bleeding.
- Determination of the presence of antibodies to HIV, hepatitis B and C.It is necessary to detect immunodeficiency or liver dysfunction, as well as to prevent infection of medical personnel.
- Ultrasound or tomography of the abdominal and pelvic organs. Allows you to assess the state of internal organs and develop tactics for surgical intervention.
- Blood group and Rh factor
- Gynecological smear for flora and cytology of the cervix
- ECG and therapist’s consultation.
The woman herself on the preoperative evening should exclude food intake, and 3 – 4 hours before the laparoscopy itself – stop drinking liquid. These precautions are necessary to prevent the development of vomiting during or after anesthesia.
How does a laparoscopic operation to remove an ovarian cyst
Carrying out such an operation is divided into several stages, each of which includes specific necessary actions:
- Anesthesia.During laparoscopy, inhalation anesthesia is used. To facilitate entry into it and relieve anxiety 12 hours before surgery, sedatives can be taken.
- Performing access. Three small incisions are made on the anterior abdominal wall through which special conductors are inserted. One hole is necessary for the introduction of the endoscope itself – a video camera with a light source, and the other two – for manipulators, with the help of which the entire operation is performed.
- Carbon dioxide is injected into the abdominal cavity, which is necessary in order to create sufficient space for all manipulations. Carbon dioxide is absolutely harmless to the peritoneum and internal organs.
- All the necessary actions are performed under the control of the video camera with the help of manipulators. In particular, opening the cyst and sucking its contents, removing the capsule and stopping bleeding.
- After evacuation of carbon dioxide, all three incisions are sutured and sterile disposable stickers are applied.
In comparison with laparotomy procedures, recovery after endoscopic procedures is much easier and faster, which determines the main advantage of this method. The hospital stay lasts up to 1-2 days, after which the woman can go home. Full working capacity is restored within 1-2 weeks.
After laparoscopic interventions, the formation of postoperative hernias is excluded, the chance of developing adhesive disease or the introduction of pathogenic microflora is minimized.
Small scars, 0.5 – 1.0 cm long, are formed at the insertion sites of endoscopic instruments, which practically do not create aesthetic defects.
Choosing a clinic for ovarian laparoscopy
Carrying out such an operation, it would seem, is not difficult. Nevertheless, the choice of a medical institution should be approached with full responsibility. The use of advanced technologies, high-quality medication, a high level of qualifications of specialists and high-quality postoperative care are the key to a quick recovery.These are the requirements that the Lapino Clinical Hospital meets.
Cost of laparoscopy for ovarian cyst
The price of laparoscopic treatment of the ovaries is formed by several indicators at once: the volume of the necessary intervention and the complexity of its implementation, the individual characteristics of the woman’s body and the course of the disease, the modernity of the equipment used, the amount of drugs administered. The low price for a laparoscopic operation should always alert and become a reason to find out its cause – the clinic may well use outdated equipment or part of the treatment and diagnostic process is banally not included in the price list.
For more information about ovarian laparoscopy, the cost of removing an ovarian cyst and other services provided related to laparoscopy, call + 7-700-700-1
Ovarian cyst – etiology, clinic and methods of treatment
Ovarian cyst is a benign neoplasm, presented in the form of a cavity on a leg with a liquid. WITH THIS TUMOR HAS A TENDENCY TO INCREASE IN SIZE.
The neoplasm under consideration can be follicular, endometrioid, paraovarian.The process can be asymptomatic or painful. The cyst is complicated by torsion of its leg, rupture of the capsule itself, which contributes to the development of peritonitis.
Physicians identify the following reasons for the development of ovarian cysts:
- hormonal dysfunction;
Some types of cysts do not manifest clinically for a long period. They are identified by gynecologists during examination.Sometimes the cyst is accompanied by the following symptoms:
- pain in the lower abdomen;
- change in the size of the abdomen;
- problems with the menstrual cycle.
To diagnose a benign process, doctors use the following methods:
- Taking anamnesis
- Two-handed gynecological examination
- MRI test
- to exclude a CT scan
- Kystectomy – consists in removing the neoplasm and preserving healthy tissues. The preserved ovary is quickly restored.
- Wedge-shaped resection – consists in excision of the cyst and the surrounding tissue.
- Complete removal of the ovary.
- Biopsy – is necessary for examining organ tissue if there is a suspicion of a cancerous process.
- feeling of fullness and heaviness;
- is tormented by soreness in the lower abdomen;
- the belly itself increases in size.
Additionally 9007 ectopic bearing of the fetus.
Methods of treatment
Therapy of ovarian cysts depends on the nature of the process under consideration, the severity of the clinic, the patient’s age and other factors. Conservative therapy is effective if the process is simple. In this case, mono- or biphasic oral contraceptives are prescribed.
The therapy lasts 2-3 menstrual cycles. Additionally, the patient is prescribed vitamin therapy and a homeopathic remedy. If indicated, diet therapy, exercise therapy, balneotherapy are prescribed.
If conservative treatment is ineffective, surgery is indicated. The task of the surgeon is the removal of the neoplasm and subsequent histology. At the first stage, laparoscopy is used if there is no suspicion of a malignant process. Otherwise, extended laparotomy is indicated.
Other methods are used to remove the cyst:
Some types of cysts, including mucinous ones, can only be treated with surgery. A similar decision is made before planning a pregnancy.
With the help of early diagnostic techniques and planned surgery, it is possible to reduce the amount of the forthcoming surgical intervention and the terms of rehabilitation.
If the process in question is detected in a girl, while there is a need to preserve reproductive function, a cystectomy or resection is prescribed, followed by the preservation of healthy tissues. If the pathology is detected in women at the age of 50, then complete removal of the uterus and its appendages is prescribed for the prevention of cancer. After such an operation, long-term rehabilitation is indicated.
To prevent complications, the cyst must be diagnosed and treated promptly.To do this, it is recommended to regularly take laboratory tests, visiting a gynecologist and other doctors.
Prognosis after therapy
The cyst is characterized by recurrence until the menstrual function is preserved. But properly selected HT helps to reduce the risk of relapse. Any hormonal agents must be taken only as directed by the attending physician.
Development of an endometrioid cyst is also allowed. But this process depends on the correct surgical treatment and subsequent therapy.The removed dermoid cyst does not reappear. After conservative or surgical treatment of the cyst, pregnancy is allowed.
Date of publication: 25.04.2018 14:26:48
Treatment of a dermoid ovarian cyst in Moscow. Affordable prices, experienced doctors.
This type of neoplasm is diagnosed in about every fifth woman diagnosed with a cyst. A dermoid cyst can develop in women of any age – from a girl to a grandmother.However, most often ovarian cysts occur in the reproductive age – from 15 to 45-50 years.
Sometimes a dermoid cyst forms in a girl in early childhood, develops very slowly and can manifest itself clinically with its gradual increase, as well as during the period of hormonal changes – adolescence, pregnancy and menopause. In 1-3% of cases, doctors note the degeneration of the dermoid ovarian cyst into squamous cell carcinoma.
Reasons for the development of a dermoid ovarian cyst
Hormonal imbalance plays a significant role in the etiology and pathogenesis of this disease.Most often, the impetus for such an imbalance is a hormonal surge during puberty or menopause.
Symptoms of a dermoid ovarian cyst
At the initial stage of the disease, there are no symptoms. Sometimes a dermoid cyst is detected during a routine examination by a gynecologist or during an ultrasound scan for other diseases of the genital area.
As a rule, tangible clinical manifestations of the dermoid ovarian cyst are associated with its growth to large sizes – up to 15 cm in diameter or more.
During this period, the woman develops the following symptoms:
In addition, a bulky cyst begins to press on the bladder and rectum, which is the cause of frequent urge to urinate, constipation or diarrhea.
In some cases, the development of complications and inflammation of the dermoid cyst is observed.In this case, the body temperature can rise to 39 ° C, there is severe weakness and sharp pain in the abdomen. This condition requires immediate medical attention!
If you have any of the symptoms described above, you need to urgently consult a gynecologist. The specialists of our medical center ON CLINIC have extensive practical experience in the diagnosis, treatment and prevention of ovarian cysts of various origins.
Dermoid ovarian cyst and pregnancy
It is best to plan pregnancy after removal of the dermoid cyst six months to a year after the operation.If pregnancy occurs with an already existing disease, but the neoplasm does not increase, does not suppurate and there is no complication in the form of torsion of the cyst leg, then the operation is postponed.
In case of progression of cyst growth, it is operated with a laparoscopic method no earlier than the 16th week of pregnancy, so as not to disrupt the gestation process and save the fetus.
After the operation, preventive examinations by a gynecologist and ultrasound control should be carried out at least twice a year.
Also, quite often the cyst is operated during childbirth carried out using a cesarean section, or after them. Recurrent development of this type of cyst is extremely rare. With the timely removal of the dermoid ovarian cyst, the prognosis for fertility is favorable.
On the video: obstetrician-gynecologist, doctor of the highest category, doctor of medical sciences, professor Ter-Hovakimyan Armen Eduardovich.
Treatment of a dermoid ovarian cyst
To date, the most effective treatment for such a cyst is surgical. Most often, laparoscopic surgery is performed, it is the least traumatic.
During the operation, a cyst with a part of the ovary is removed in girls and young women (cystectomy), in premenopausal women, a complete removal of the ovary is performed (oophorectomy), sometimes adnexectomy (not only the ovary, but also the fallopian tube is removed).
If the cyst on the pedicle is twisted, then an emergency operation is required, since the situation threatens the patient’s life.
After removal of the dermoid cyst, the patient is prescribed anti-adhesion therapy.