What are the symptoms of ovarian cancer? What are the differences between ovarian cancer and ovarian cysts? Find the answers to these questions and more.

Ovarian Cancer Symptoms: What to Look For

Ovarian cancer, a type of gynecologic cancer, begins when the genes that regulate cell growth mutate and allow abnormal cells to thrive. These rogue cells multiply at a rapid rate and eventually form a tumor. Left untreated, ovarian cancer can spread to other areas of your body. Ovarian cancer rates are highest in women in their early to mid-60s.

Although ovarian cancer is considered rare in women under 40, it’s important to know that women of all ages can develop ovarian cancer. Fertility treatments, endometriosis, obesity, and a family history of ovarian, breast, or uterine cancer can increase your risk of developing ovarian cancer.

Only 19 percent of women who discover they have ovarian cancer are diagnosed in the early stages. Diagnosing ovarian cancer can be more difficult because there are no routine tests to effectively screen for the disease. That’s why all women should consult their physician if they experience any of the following signs and symptoms of ovarian cancer:

• Changes in appetite
• Menstrual changes
• Abdominal bloating or increasing size
• Pelvic discomfort
• Frequent urination
• Fatigue or low energy
• Unintentional weight loss
• Gastrointestinal disturbances
• Leg swelling

Early Ovarian Cancer Symptoms: Why They Can Be Tricky

In its earliest stages, ovarian cancer does not cause symptoms. As the disease progresses, there may be symptoms, but many women ignore the warning signs because the symptoms of ovarian cancer mimic so many other far less serious concerns. That’s why all women should pay close attention to their bodies, stay alert for changes in their health, and resist the temptation to self-diagnose. Unusual symptoms should not be ignored.

Early detection of ovarian cancer can impact the outcome of treatment. You should consult your healthcare provider if you are experiencing any of these troubling symptoms more than 12 days per month or if you have consistent symptoms for more than two weeks.

Changes in Appetite: A Potential Ovarian Cancer Symptom

Yes, there are many possible explanations for variations in your appetite. But if you have unexplained changes that cannot be explained by temporary digestive disturbances or stress, it’s important to bring your symptoms to the attention of your healthcare provider. Changes in appetite can be one of the first signs of ovarian cancer. Many women find they feel unusually full after eating a small amount of food. If you have ovarian cancer, you might find it difficult to finish even a small meal regardless of how hungry you felt before eating. Some women find eating causes nausea and vomiting.

Menstrual Changes: A Sign of Ovarian Cancer?

Although irregular periods are not necessarily a sign of ovarian cancer, a history of irregular cycles can increase your risk. Some women diagnosed with ovarian cancer report menstruating more frequently than once each month or note spotting between periods. If you are not yet menopausal and suddenly have an irregular cycle or more period pain than usual, you should consider scheduling an appointment with your gynecologist. This is especially true if you are taking oral birth control. If you are post-menopausal, any unexpected bleeding should be investigated by your healthcare provider.

Abdominal Bloating: A Common Ovarian Cancer Symptom

Bloating is a common complaint noted by researchers investigating the signs of ovarian cancer. Before they are diagnosed, many women initially assume their abdominal distention is caused by age, fluid retention, or unhealthy diet. The bloating caused by ovarian cancer can be mild or severe. Some women find their bloating so pronounced they need to buy larger clothes. An expanded waistline can be caused by increasing tumor size or by fluid retention in the abdomen (ascites) experienced by people with liver disease or some types of cancer. Abdominal bloating may be accompanied by digestive disturbances or changes in appetite, but you can experience bloating or increased girth with or without abdominal discomfort.

Ovarian Cancer vs. Ovarian Cysts: What’s the Difference?

Ovarian cysts are fluid-filled sacs that form on one or both ovaries. They are very common and often harmless. In contrast, ovarian cancer is a serious and potentially life-threatening condition that occurs when abnormal cells in the ovary grow and multiply uncontrollably.

While ovarian cysts may cause symptoms like pelvic pain, bloating, and changes in menstrual cycles, these symptoms are generally less severe than those associated with ovarian cancer. Ovarian cysts also tend to come and go, whereas ovarian cancer symptoms are more persistent.

If you have any concerns about ovarian cysts or ovarian cancer, it’s important to consult with your healthcare provider. They can perform tests and examinations to determine the cause of your symptoms and provide appropriate treatment recommendations.

The 9 Signs of Ovarian Cancer Every Woman Needs to Know

Ovarian cancer, a type of gynecologic cancer, begins when the genes that regulate cell growth mutate and allow abnormal cells to thrive. These rogue cells multiply at a rapid rate and eventually form a tumor. Left untreated, ovarian cancer can spread to other areas of your body. Ovarian cancer rates are highest in women in their early to mid-60s.

Although ovarian cancer is considered rare in women under 40, it’s important to know that women of all ages can develop ovarian cancer. Fertility treatments, endometriosis, obesity, and a family history of ovarian, breast, or uterine cancer can increase your risk of developing ovarian cancer.

Only 19 percent of women who discover they have ovarian cancer are diagnosed in the early stages. Diagnosing ovarian cancer can be more difficult because there are no routine tests to effectively screen for the disease. That’s why all women should consult their physician if they experience any of the following signs and symptoms of ovarian cancer.

1. Changes in appetite
2. Menstrual changes
3. Abdominal bloating or increasing size
4. Pelvic discomfort
5. Frequent urination
6. Fatigue or low energy
7. Unintentional weight loss
8. Gastrointestinal disturbances
9. Leg swelling

In its earliest stages, ovarian cancer does not cause symptoms. As the disease progresses, there may be symptoms, but many women ignore the warning signs because the symptoms of ovarian cancer mimic so many other far less serious concerns. That’s why all women should pay close attention to their bodies, stay alert for changes in their health, and resist the temptation to self-diagnose. Unusual symptoms should not be ignored.

Early detection of ovarian cancer can impact the outcome of treatment. You should consult your healthcare provider if you are experiencing any of these troubling symptoms more than 12 days per month or if you have consistent symptoms for more than two weeks.

1.

Changes in Appetite

Yes, there are many possible explanations for variations in your appetite. But if you have unexplained changes that cannot be explained by temporary digestive disturbances or stress, it’s important to bring your symptoms to the attention of your healthcare provider. Changes in appetite can be one of the first signs of ovarian cancer. Many women find they feel unusually full after eating a small amount of food. If you have ovarian cancer, you might find it difficult to finish even a small meal regardless of how hungry you felt before eating. Some women find eating causes nausea and vomiting. 

2. Menstrual Changes

Although irregular periods are not necessarily a sign of ovarian cancer, a history of irregular cycles can increase your risk. Some women diagnosed with ovarian cancer report menstruating more frequently than once each month or note spotting between periods. If you are not yet menopausal and suddenly have an irregular cycle or more period pain than usual, you should consider scheduling an appointment with your gynecologist. This is especially true if you are taking oral birth control. If you are post-menopausal, any unexpected bleeding should be investigated by your healthcare provider.

3. Abdominal Bloating

Bloating is a common complaint noted by researchers investigating the signs of ovarian cancer. Before they are diagnosed, many women initially assume their abdominal distention is caused by age, fluid retention, or unhealthy diet. The bloating caused by ovarian cancer can be mild or severe. Some women find their bloating so pronounced they need to buy larger clothes. An expanded waistline can be caused by increasing tumor size or by fluid retention in the abdomen (ascites) experienced by people with liver disease or some types of cancer. Abdominal bloating may be accompanied by digestive disturbances or changes in appetite, but you can experience bloating or increased girth with or without abdominal discomfort.

4. Pelvic Discomfort

Since period pain is common and most often considered normal, many women initially blame their menstrual cycles for the pelvic discomfort caused by ovarian cancer. Some blame digestive disturbances, noting heartburn, bloating, constipation, and gas. But it’s important to know that pelvic pain in your abdomen, hip area, or lower back could be a sign of ovarian cancer. When tumors spread in the abdomen or pelvis, they can irritate tissues in your lower back. If pelvic discomfort is new to you, or increases in intensity, consider scheduling an appointment with your gynecologist.

5. Frequent Urination

Your bladder and ovaries are close together. Tumors or swelling in or around your ovaries can cause urinary disturbances. Many women with ovarian cancer find they feel the urge to urinate more frequently in the weeks or months before their diagnosis. Some assume they have a urinary tract infection because the symptoms are similar. If you have ovarian cancer you may notice increased urgency, burning pain with urination, bladder spasms, or difficulty emptying your bladder.

6. Low Energy or Fatigue

Ordinarily, a little rest is all you should need to recover when you feel tired. If you find you have significantly less energy than usual or do not feel refreshed after an adequate amount of sleep, it’s important to notify your health care provider. Scheduling an appointment is particularly important if constant fatigue is interfering with your ability to enjoy your usual activities. Although there are numerous potential causes of unrelenting fatigue, loss of energy and fatigue can be a sign of ovarian cancer.

7. Unintentional Weight Loss

If you’ve lost more than five percent of your body weight over the past six to twelve months without changes to your diet or exercise habits, it may be time to consult your physician. Nearly 40 percent of people first diagnosed with cancer report unexplained weight loss. Women with advanced ovarian cancer may also experience cachexia, a syndrome resulting in weight loss and muscle wasting. Cachexia can be caused by substances manufactured by tumors or an immune system response to the disease itself.    

8. Gastrointestinal Disturbances

Gastrointestinal symptoms are the most commonly reported complaints leading to an ovarian cancer diagnosis. Women ignoring gastrointestinal disturbances are considerably more likely to be diagnosed in the later stages of the disease. That’s why it may be important to know that many of the initial signs of ovarian cancer mimic the symptoms of irritable bowel syndrome, a condition caused by hypersensitivity in the small intestine. Since both conditions can cause abdominal pain, bloating, diarrhea, and constipation, women experiencing IBS symptoms for three weeks or more should talk with their doctor about ovarian cancer testing.   

9. Leg Swelling

One of the first signs of ovarian cancer could be fluid retention in your feet, ankles, or lower legs. Fluid accumulation could cause your legs to feel unusually heavy.  As swelling progresses, your skin may look stretched or shiny. Swollen areas may remain indented after applying pressure, a condition is known as pitting edema. Although leg swelling can be caused by several unrelated health concerns, ovarian cancer is one of several cancer types known to cause edema. About 20 percent of women diagnosed with ovarian cancer develop leg swelling.

Although the many possible symptoms can be explained by other conditions not related to ovarian cancer, your symptoms should not be dismissed as unimportant. The many potential symptoms of ovarian cancer are often overlooked until the disease has progressed.

If the results of your examination or imaging tests suggest you may have ovarian cancer, your healthcare provider will likely recommend consulting with a gynecological oncologist, a specialist who treats cancers of the female reproductive system.

Virginia Oncology Associates specialize in the diagnosis and treatment of cancer and blood disorders, including cancers of the female reproductive system. With locations spanning southeast Virginia and Northeastern North Carolina, we are committed to improving lives by providing personalized, compassionate, state-of-the-art care. Our cancer centers are located throughout cities in Hampton Roads and Eastern North Carolina, including in Virginia Beach, Norfolk, Hampton, Williamsburg, Chesapeake, Suffolk, Newport News, and Elizabeth City.  

Doctors Never Took Me Seriously Until I Was Diagnosed With Ovarian Cancer at 24

For as long as I can remember, I’ve been insecure about my stomach.

I took up powerlifting when I was 21 years old, which made me feel more in control of my body. But while it toned my arms and legs, my stomach still stuck out like I was bloated.

My abdomen was also a source of physical pain. Since I was about 15 years old, I’d randomly feel sharp jolts in my lower right side. The sensation was somewhere between a period cramp and a stabbing sensation.

I knew something had to be wrong. So over the next nine years, I made sure to mention this mysterious pain to three primary-care physicians and four gynecologists. But every time I brought it up, they brushed it off.

After all, I was 5’2″ and weighed 185 pounds. Even though I was extremely muscular, that meant I was obese on paper. Each doctor made me feel like my bloating issues and sudden aches could be solved with lean protein, portion control, and cutting carbs. I always explained how careful I was with my diet, but it didn’t seem to matter to them.

By summer 2017, I was 24. It had been several years since I first flagged the sudden cramps to my doctors, and now the cramps were hitting almost daily. I still had no idea what was going on.

That August, I was walking on the Wildwood, New Jersey, boardwalk with my boyfriend, Joe, when I buckled over in pain. It felt like someone hit me across the pelvis with a shovel. When Joe begged me to see a doctor, I rolled my eyes. I had an annual with my gynecologist the following month and decided I’d bring up my symptoms again.

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But just like every other time, she shrugged off my concerns. Instead, she addressed my diet: “Some people just need to work a little harder,” she said after I insisted I was careful about what I ate. She added that if I was “really that concerned” about the pain, she could do an ultrasound to see if there was anything to worry about. Her dismissive tone made me feel like the expensive procedure would be a waste. So I let it go.

Over the next few weeks, the pain migrated from my right side to my stomach to my arms and legs. My whole body was radiating with cramp-like pain. Sometimes, it hurt so bad, I couldn’t get out of bed. My thirst was unquenchable, and I constantly felt full.

At the time, I was super busy with a big work project, so I chalked up my symptoms to stress. And since my primary-care physician and go-to gyno couldn’t find anything wrong with me, I figured it would pass. Little did I know, these were textbook symptoms of ovarian cancer.

By the end of October, the cramping became so severe that I had to miss work. I finally went to an urgent-care center. During my exam, the doctor gently touched my abdomen and it hurt so much, I literally jumped. He recommended I get an MRI immediately.

In the hospital emergency room, the doctor ordered a transvaginal ultrasound rather than an MRI to save money and time. Still, I couldn’t shake the feeling that something was very, very wrong. Tears streamed down my face throughout the 20-minute procedure.

After waiting for hours, an ER doctor told me I had a common cyst that would go away on its own. He prescribed Tylenol. I went home and felt like an idiot.

The next day, while cradling a heating pad in bed, the same doctor called to say he’d misread the scan. The cyst was actually closer to 10 centimeters in diameter. “Anything of this size is worrisome for cancer,” he told me.

I shot up. It was the first time I’d even considered I might have cancer. He told me I should make an appointment with my gynecologist ASAP.

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Later that day, I went into my gyno’s office for another scan. A nurse practitioner filling in for my regular doctor suggested it might be an operable dermoid cyst, a benign mass that starts growing at birth. Although cancer was at the forefront of my mind, the nurse practitioner repeatedly told me the chance the mass was cancer was less than 1 percent.

I scheduled a preoperative appointment with a new ob-gyn—my regular gyno was away—for the following week. In his office, the doctor, who had reviewed my blood work, said I had a slightly elevated level of a cancer antigen called CA 125, which can detect ovarian cancer. He told me not to worry but that he’d run some extra blood tests just to be safe. I scheduled surgery for three days later.

Once I’d checked into the hospital on the day of my surgery, I was sent to the nurse’s station to take a call. I was so confused.

I held the phone to my ear. It was my doctor calling to tell me he’d canceled my surgery. My blood tests revealed alarmingly high levels of the protein AFP and the enzyme LDH, which signaled that the mass was actually a cancerous tumor.

Everything around me went blurry. After that, the only thing I remember him saying was “likely cancer” and “see our oncologist.” I didn’t realize I was shaking until a nearby nurse tried to calm me down. My mom, who’d taken me to the hospital, heard me panicking and rushed over to hold me as I sobbed.

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At my family’s house later that day, I remained dazed as my parents worked to find new doctors. My boyfriend sat beside me, obsessively googling my blood results. He hoped that my diagnosis was some kind of medical mistake. My brother was there, too, nodding as I said, “I’m not the kind of person who gets cancer,” over and over.

A few days later, I went to Memorial Sloan Kettering Cancer Center in New York to meet an oncologist. I looked like the youngest person in the unit.

I met with my surgeon, who reviewed my test results and quickly diagnosed me with a malignant ovarian germ-cell tumor. She told me it was definitely cancerous and extremely rare. In fact, only about 2 percent of ovarian cancers are in this form. Still, she couldn’t say for sure if the mass had been growing for years or just a few months.

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She said my pain was likely getting worse over the past few weeks as the growing tumor weighed down my right ovary like an anchor, causing it to twist. She assured me it was curable, but I’d need the mass removed as soon as possible.

I don’t know if I was numb or relieved to finally have a definitive answer, but I didn’t cry. For the first time in my life, a doctor took me seriously and found an answer rather than dismissing me. I was obviously devastated and afraid, but I also felt every concern I ever had was validated. I wanted to tell every doctor who blew me off, “F*ck you. ”

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Later that day, I told my boss I’d be out of work for longer than I expected and I had cancer. It felt so surreal to say out loud.

On November 2, 2017, the Sloan Kettering team took out my tumor, my right ovary, and right fallopian tube. When they opened me up, surgeons discovered the honeydew-size mass was pushing against my kidney. It measured about 7 inches across. During the two-hour surgery, doctors also biopsied surrounding organs to check whether the cancer had spread.

I was in the hospital for five days after. My mom slept on a stiff chair next to my bed every night. She stayed by my side as I screamed in pain from the surgery and cried about not knowing what would come next.

At this point, my pathology report hadn’t come back. I didn’t know what stage my cancer was, if it had spread, or if I would need chemo. All the unknowns gave me more anxiety than I’d ever felt. A week and a half after the surgery, my parents drove me through an hour and a half of rush-hour traffic into Manhattan to find out.

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The good news: My cancer was stage 1A—meaning it was contained inside my ovary and hadn’t spread anywhere else. The bad news: It was grade 3—meaning if it did spread, it would be rapid.

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There was a small chance a few remaining cancer cells could grow into something worse than before, so I’d need chemotherapy to make sure it was gone for good. I felt the wind knocked out of me. I hated the idea of cancer affecting the way I felt and the way I looked.

At that point, I was shocked that none of my doctors had caught this. The tumor was giant and my gynecologist never even bothered to touch my stomach when I complained of pain. I fixated on whether I even would need chemo had someone caught this sooner, although my doctors wouldn’t say if that was the case.

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I did three cycles of aggressive intravenous chemo. Each one was three weeks long. During that time, I felt like I had the worst hangover of my life times 10.

I didn’t want cancer to completely take over my life, so I kept working through my last cycle before I went on medical leave. But by the end of my first cycle, my hair started falling out.

Just before the beginning of my second chemo cycle, most of my hair was gone and the rest was matted and knotted together. My scalp was so tender I couldn’t brush it, and the chemo kept my head from producing oils that my strands needed to stay soft and moisturized. I impulsively decided to buzz it off.

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When it was over, I couldn’t look in the mirror or even force myself to touch my scalp. I didn’t want to know what having no hair felt like. Instead, I just took a deep breath. To me, the worst was finally behind me.

Feeling a sense of closure, I decided to write my former gyno a letter explaining everything that went down after I switched doctors. I told her that my tumor was, despite what her team told me, 100 percent cancerous and suggested they work on their bedside manner. She wrote back with no apology, ending her note with, “I wish you all the best.” Still, I said what I needed to say, so I was satisfied.

As I finished chemo, I started to find some peace with my old doctors who missed my cancer. I stopped asking myself, What if it were caught earlier? or What if there were something I could have done to prevent this? I realized I had to let go of all those questions to end this miserable chapter of my life.

Cancer had taken a physical and emotional toll on me, and I couldn’t let obsessing over the past consume me too. All I cared about was getting better and notifying the doctors of what they missed. I didn’t want them making the same mistake again with someone else.

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About two weeks after I finished chemo, I received a bill from my former gynecologist: $12.99 for an ultrasound. In the grand scheme of cancer bills, this was barely a drop in the bucket. But rather than paying, I sent the affiliated hospital a letter explaining why they didn’t deserve my $13. I haven’t heard back.

Today, I’m officially in remission.

Even though the scars will fade and I’ll eventually have my long, curly hair back, the mental toll of my illness likely will follow me forever. I’ll never be able to brush off a random ache without fearing it’s more cancer that my doctors won’t catch.

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Still, I control what I can. I’m back in the gym, building up my strength so I can finally feel like myself again, I make jokes to cope when someone brings up the C word, and I don’t let myself feel dumb about being the person who asks doctors a thousand little questions.

At the end of the day, I tell myself that I’ve done everything in my power to have my own back. No patronizing or dismissive doctor can take that away from me.

Related Story

• For 6 Years, My Doctor Didn’t Believe My Symptoms

Amanda Kabbabe

Amanda is the Executive Producer of TV and video development at Hearst Magazines. She focuses on developing unscripted and docu-style content for linear and streaming platforms, as well as lifestyle digital content across the Hearst Magazines brands. 

Ovarian cysts (polycystic ovaries): treatment, symptoms, causes

Ovarian cyst – a gynecological female disease. It looks like a benign tumor. There are several types of ovarian cysts that differ in signs, stages, and genetic predisposition. With the development of the disease in the female body, she does not show signs: only after a while the patient feels discomfort. Her menstrual cycle is interrupted, and pain is felt in the lower abdomen.

Symptoms of the disease

Primary signs are practically not diagnosed. But the cyst exfoliates and causes invisible harm to the female body. Irregular periods are among the most common symptoms, but this symptom points to many other diseases. Also, an ovarian cyst manifests itself through:

1. Aching pain in the lower abdomen, a feeling of heaviness in this part of the body. Together with them, a stable high temperature and headache are felt.

2. Pain in the lower abdomen during intercourse.

3. Regular uterine bleeding.

4. Nausea or vomiting after exercise.

5. Seals in the abdominal cavity.

6. Constant thirst, rapid weight loss, inattention, fatigue and irritation.

7. Asymmetry of the abdomen due to enlargement of the tumor. It can compress blood vessels or put pressure on the bladder.

Diagnosis

The cyst of both ovaries is leaking without a trace, so it is necessary to check in the hospital. The doctor applies a manual examination. Testing is used for diagnosis. An effective method that detects a cyst is ultrasound treatment. Thanks to him, it becomes clear where the disease is localized: on the screen it looks like a dark spot, as well as its size. After an ultrasound, the gynecologist determines the type of cyst and decides how to treat the disease – medical or surgical.

For the diagnosis of ovarian cysts, the following is used:

• computed tomography;
• laparoscopy;
• general analysis – to identify the condition of the genital organs;
• magnetic resonance imaging;
• analysis for the detection of cancer cells.

Diagnostic methods allow you to determine at what stage the disease is, and what treatment is suitable in a particular case.

Treatment

Most types of disease resolve themselves over time. To avoid surgery, it is necessary to correctly approach the treatment and stabilize the hormonal background. These questions will help to competently solve the attending physician. Based on the results of the tests and ultrasound, he draws up a treatment plan. This includes special contraceptives and hormonal preparations. Treatment includes antibacterial drugs, as well as medications that relieve inflammation. A woman needs to physiologically recover.

If medical treatment fails, an operation is scheduled. Surgical intervention is necessary if the patient is in agony and pain. With pronounced symptoms of the disease, endoscopy is used. After the operation, the patients undergo a recovery course that lasts from 7 to 30 days.

Do not self-medicate when removing a cyst. There are several types of the disease, and a specific one can only be determined in a hospital. For the treatment of each type of cyst, an individual approach is used. They get rid of the cyst in a month, if the right treatment is chosen.

Doctors of the department

Melodyeva Elena Viktorovna

Obstetrician-gynecologist of the highest medical qualification category, work experience 25 years

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Guinea pig polycystic and ovarian tumors

In January, the owners of the guinea pig Manya turned to the Svoy Doktor Krasnogorsk clinic. Age 5 years. Body weight 1200 g. The main complaint was an increase in the volume of the abdomen over the past month.

Content is cellular. Feeding: hay, industrial feed for rodents, fresh vegetables. Appetite, thirst and activity have not changed. The pig became a little less mobile.

On examination at the reception revealed an asymmetric increase in the abdomen. The abdominal wall is tense, painless. Body temperature is normal. Breathing quickened.

Together with the owners, it was decided to conduct an ultrasound examination of the abdominal organs.

According to ultrasound : volumetric formations in the abdominal cavity, predominantly with liquid contents, with a diameter of more than 7 cm, with the inclusion of dense (tissue) structures. Localization: presumably – the area of ​​the ovaries. Uterus: the horns are expanded to 6 mm, the walls are thickened.

The bowel loops are displaced cranially (forward). Peristalsis is slow. Kidneys: not enlarged, the structure is not changed. Visualization of other organs was difficult due to the large size of these formations.

Conclusion: ultrasound signs of bilateral (bilateral) ovarian neoplasia. Ovarian cysts. Intestinal hypotension.

Given the suspicion of a tumor process in the ovaries, cyst puncture was contraindicated. But the size of the formations was so large that it already caused shortness of breath due to pressure on the diaphragm. The only effective treatment in this case is surgery. All the risks and expected benefits of the operation were discussed with the owner of Mani, and a decision was made on surgical treatment.

On the day of the operation, Manya was admitted to the hospital, her general condition was satisfactory. Ovariohysterectomy (removal of the ovaries and uterus) was performed under general anesthesia. These are the cysts and tumors of the ovaries were in a small animal.