Ovarian Cysts & Tumors

Most ovarian cysts are self-limited and benign. Let us work with you to determine the next step in the care of your ovarian cyst. In the reproductive years—a 2cm cyst occurs monthly with ovulation. Chances of ovarian cancer are small-so don’t worry too much before your visit—come in and we will develop a diagnosis plan!

The ovaries are two small organs located on either side of the uterus in a woman’s body. They make hormones, including estrogen, which trigger menstruation. Every month, the ovaries release a tiny egg. The egg makes its way down the fallopian tube to potentially be fertilized. This cycle of egg release is called ovulation.

What causes ovarian cysts? Cysts are fluid-filled sacs that can form in the ovaries. They are very common. They are particularly common during the childbearing years.There are several different types of ovarian cysts. The most common is a functional cyst. It forms during ovulation. That formation happens when either the egg is not released or the sac -- follicle -- in which the egg forms does not dissolve after the egg is released.

  • Polycystic ovaries. In polycystic ovary syndrome (PCOS), the follicles in which the eggs normally mature fail to open and cysts form.
  • Endometriomas. In women with endometriosis, tissue from the lining of the uterus grows in other areas of the body. This includes the ovaries. Endometriosis can be very painful and can affect fertility.
  • Cystadenomas. These cysts form out of cells on the surface of the ovary. They are often fluid-filled.
  • Dermoid cysts. This type of cyst contains tissue similar to that in other parts of the body. That includes skin, hair, and teeth.

What causes ovarian tumors? Tumors can form in the ovaries, just as they form in other parts of the body. If tumors are non-cancerous, they are said to be benign. If they are cancerous, they are called malignant. There are three types of ovarian tumors:

  • Epithelial cell tumors start from the cells on the surface of the ovaries. These are the most common type of ovarian tumors.
  • Germ cell tumors start in the cells that produce the eggs. They can either be benign or cancerous. Most are benign.
  • Stromal tumors originate in the cells that produce female hormones.

What are the symptoms of ovarian cysts and tumors? Often, ovarian cysts don’t cause any symptoms. You may not realize you have one until you visit your obstetrician/gynecologist for a routine pelvic exam. Ovarian cysts can, though, cause problems if they twist, bleed, or rupture. If you have any of the symptoms below it’s important to have them checked out. That’s because they can also be symptoms of ovarian tumors. Ovarian cancer often spreads before it is detected. Symptoms of ovarian cysts and tumors include: pain or bloating in the abdomen, difficulty urinating, or frequent need to urinate, dull ache in the lower back, pain during sexual intercourse, painful menstruation and abnormal bleeding, weight gain, nausea or vomiting, loss of appetite, feeling full quickly.

How do doctors diagnose ovarian cysts and tumors?

  • Ultrasound. This test uses sound waves to create an image of the ovaries. The image helps the doctor determine the size and location of the cyst or tumor.

  • Magnetic resonance imaging (MRI)
  • Hormone levels. The doctor may take a series of blood tests to check several hormones. These include luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, progesterone, testosterone and maybe CA125 (only 50% accurate), AFP, HCG, LDH to check for rare cancer.
  • Laparoscopy. A surgical procedure rarely used to treat persistent ovarian cysts. It uses a thin, light-tipped device inserted into your abdomen. During this surgery, the surgeon can find cysts or tumors and may remove them through very small incisions and the removed tissue will be sent to be tested for cancer. You will be discharged from the surgicenter on the same day.

If the diagnosis is ovarian cancer, we refer and work very closely with our gynecologic associates to provide expeditious and robotic care for our

Most ovarian cysts will go away on their own—as they are a variation of NORMAL physiology of your normal monthly cycle. If you don’t have any bothersome symptoms, especially if you haven’t yet gone through menopause, your doctor may advocate “watchful waiting.” But if it is painful—we will use cooperative progesterone treatment (orally and injections) quickly to resolve the abnormal cyst and pain. An US will be done on the day of your office visit and again on the next cycle Day 5 of your menses. We may check you every one to three months to see if there has been any change or recurrent in the cyst. Birth control pills are rarely if ever necessary to treat abnormal ovarian cysts in our practice.


© Copyright 2012, Mary J. Kotob, MD, FACOG. All rights reserved.
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