What are benign cysts & ovarian tumours?

Benign cysts and ovarian tumours grow in the ovaries and are not cancerous. They can occur in women of all ages, but are more common in women of childbearing age. Ovarian cysts are fluid-filled sacs that grow in the ovaries. Most ovarian cysts are functional cysts, meaning they are associated with the menstrual cycle and often resolve on their own without treatment. However, some cysts can become large, cause pain or other symptoms and may need treatment.  Like cysts, most ovarian tumours are benign, meaning they are not cancerous. However, some ovarian tumours can be cancerous, so it is important to have a proper diagnosis and treatment plan.

What are the most common symptoms caused by ovarian cysts & tumours?

Symptoms of benign ovarian tumours vary depending on their size and location. Some common symptoms include:

• Abdominal or pelvic pain: This can range from mild discomfort to severe pain and can be continuous or intermittent.
• Bloating or abdominal swelling: Benign cysts and ovarian tumours can make the abdomen look swollen or larger than usual.
• Changes in the menstrual cycle: This may include irregular periods, heavy or prolonged bleeding or spotting between periods.
• Pain during sexual intercourse: Some women may feel pain or discomfort during sexual intercourse.
• Difficulty in emptying the bladder: Large cysts or ovarian tumours can put pressure on the bladder, causing difficulty urinating or frequent urination.
• Gastrointestinal symptoms: In some cases, benign cysts or ovarian tumours can cause nausea, vomiting or diarrhoea.
• Unusual hair growth on the face and body: caused by increased production of male hormones (shaggy hair).

It is important to note that many women with benign cysts or ovarian tumours may not show symptoms and may be discovered incidentally during a routine examination or imaging test. 

What are the types of benign ovarian tumours?

There are several types of benign ovarian tumours. Some common types include:

Serous cystadenoma: It is a cyst with clear fluid that develops from cells on the surface of the ovary. It is the most common type of benign ovarian tumour.

Mucinous cystadenoma: It is a cyst filled with gelatinous substance and also comes from the surface cells of the ovary. They can grow quite large and can cause abdominal discomfort or pain.

Dermoid cyst: Also known as a teratoma, these are tumours that contain tissue from all three embryonic layers (exoderm, mesoderm and endoderm). They may contain hair, teeth, bone and other types of tissue and can cause pain or discomfort.

Brenner volume: These are rare tumours that arise from the cells lining the ovary. They are usually small and cause no symptoms.

Inoma: They are tumours that originate in the connective tissue of the ovary. They can be solid and can cause pain or pressure in the abdomen.

Case: These are tumours that produce oestrogen and can cause menstrual disorders or other hormonal changes.

It is important to note that these are only a few examples of benign ovarian tumours and that there are other types.

Functional ovarian cysts

Functional cysts are formed by the fluid-filled cavities (follicles) in the ovaries. Each follicle contains one egg. Usually, during each menstrual cycle, a follicle releases an egg and the follicle leaves after the egg is released. However, if an egg is not released, the follicle may continue to enlarge, forming a larger cyst. About a third of premenopausal women develop such cysts. Functional cysts usually disappear on their own after a few days or weeks. There are two types of functional cysts:

Vitreous cysts: These cysts form as the egg develops in the follicle.

Cysts of corpus luteum: These cysts develop from the structure that forms after the follicle ruptures and the release of the ovum. This structure is called the corpus luteum. The corpus luteum cysts may bleed, causing the ovary to swell, or they may rupture. If the cyst breaks, fluids escape into the abdomen (the abdominal cavity) and can cause severe pain.

How are ovarian cysts & tumours diagnosed?

The examination is essential for their diagnosis. 

Gynaecological examination: Often, ovarian cysts are detected during a regular gynaecological examination. However, because a pelvic exam cannot give a definitive diagnosis, the next step is to perform a vaginal ultrasound.

Vaginal ultrasound: This imaging test allows the doctor to get a more accurate picture of the ovary and bladder. The test is performed by inserting a small ultrasound head into the vagina and enables the doctor to accurately determine the size of the cyst and, just as importantly, to look inside and identify whether it is solid or full of fluid.

Laparoscopy: This minimally invasive surgical procedure allows your doctor to see and remove the cyst by making a small incision in the abdomen. The laparoscope, a camera with a thin light, is inserted through a small incision in your abdomen. Small instruments are inserted and allow the doctor to then remove the cyst.

How are they treated cysts & ovarian tumours;

Treatment options for these conditions depend on the type and size of the cyst or tumour, the woman's age, symptoms and fertility goals. Here are some common treatment options:

Monitoring: Small, asymptomatic ovarian cysts may not require treatment and the gynaecologist may recommend monitoring the cyst over time to ensure that it does not develop or cause complications.

Surgery: If the cyst or tumour is large, causes symptoms or is suspected to be cancerous, surgery may be recommended. Surgery may involve removing the cyst or tumour while preserving the ovary or removing the entire ovary (oophorectomy). Surgery may be performed using open surgery, laparoscopy or robot-assisted surgery.

Hormonotherapy: Hormonal therapy, such as birth control pills, can help regulate the menstrual cycle and prevent the development of ovarian cysts in some cases.

Provisioning: In some cases, a cyst can be drained using a needle, which can help relieve symptoms, but this is not a permanent solution as the cyst may reappear. The choice of treatment depends on several factors, such as the size and type of cyst or tumour, the woman's age and fertility goals, and the presence of symptoms. Women should discuss their options with their gynecologist to determine the best treatment approach based on their individual needs as well.