Ovarian cysts are a common occurrence, often presenting as fluid-filled sacs on or within an ovary. While their discovery can naturally raise concerns about cancer, the vast majority of these growths are benign and do not indicate malignancy.
Understanding Ovarian Cysts
Ovarian cysts are sacs, typically filled with fluid, that form on or inside the ovaries. Many individuals develop at least one during their lifetime. Often, these cysts are asymptomatic and discovered incidentally during a pelvic exam or imaging for another reason.
Cysts are categorized into two main types: functional and pathological. Functional cysts are the most common and develop as a normal part of the menstrual cycle. Pathological cysts are less common and arise from abnormal cell growth, independent of the menstrual cycle.
Distinguishing Benign and Malignant Cysts
Functional cysts, such as follicular and corpus luteum cysts, are benign types directly related to ovulation. Follicular cysts occur when a follicle grows and fills with fluid instead of releasing an egg. Corpus luteum cysts form after an egg is released, but the follicle remnant fills with fluid or blood. These functional cysts typically resolve on their own within a few weeks or months.
Other common benign pathological cysts include dermoid cysts, which can contain various tissues like hair or skin, and cystadenomas, which are fluid-filled growths on the ovary’s surface. Endometriomas, often called “chocolate cysts,” are another type that forms in individuals with endometriosis. While these benign types are not a concern for cancer, certain characteristics can raise suspicion for malignancy. Features such as solid components within the cyst, an irregular shape, rapid growth, a larger size (e.g., over 10 cm), or the presence of fluid in the abdomen (ascites) can indicate a higher risk of cancer. The risk of malignancy also increases with age, particularly after menopause.
How Malignancy is Evaluated
When an ovarian cyst is identified, healthcare providers employ various diagnostic methods to assess the likelihood of malignancy. Transvaginal ultrasound is the primary imaging tool, providing detailed images of the ovaries. It allows doctors to evaluate the cyst’s size, internal structure (simple, complex, solid areas, septations), and blood flow patterns. Suspicious ultrasound findings include thick, irregular walls, solid growths, or increased blood supply within the cyst.
Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be used for further evaluation if ultrasound results are inconclusive. Blood tests, such as the CA-125 tumor marker, can also provide additional information. CA-125 levels can be elevated due to many benign conditions like endometriosis or pelvic inflammatory disease, not solely cancer. Patient age, menopausal status, and family history of ovarian cancer are also considered during the evaluation process.
When to Seek Medical Attention
While many ovarian cysts cause no symptoms, certain signs warrant prompt medical evaluation. These include persistent pelvic or abdominal pain, bloating that does not resolve, changes in bowel or bladder habits such as increased urgency or frequency, or feeling full quickly after eating. Unexplained weight loss or fatigue can also be concerning symptoms.
Consult a healthcare professional for any new or worsening symptoms, especially if an ovarian cyst has previously been identified. Prompt medical assessment is important for managing potential issues related to ovarian cysts.