Ovarian cysts are fluid-filled sacs that can develop on an ovary. Many women experience them at some point in their lives. While most ovarian cysts are benign and resolve without intervention, the discovery of a larger cyst, such as one measuring 8 cm, can cause concern.
Understanding Ovarian Cysts
Ovarian cysts typically form as a part of the menstrual cycle, known as functional cysts. Follicular cysts, the most common type, occur when a follicle containing an egg does not rupture and release the egg, instead continuing to grow and fill with fluid. Another type, a corpus luteum cyst, forms after an egg has been released, if the sac seals off and fluid accumulates inside. Functional cysts are usually harmless and often disappear within a few menstrual cycles.
Beyond functional cysts, other types, referred to as pathological cysts, arise from abnormal cell growth and are not directly tied to the menstrual cycle. These include dermoid cysts, which may contain various tissues like hair or skin; endometriomas, associated with endometriosis; and cystadenomas, which develop from the surface of the ovary and can become quite large. Most ovarian cysts are not cancerous.
The Significance of Size
Cysts larger than 6 cm raise concern due to an increased likelihood of complications. One complication is ovarian torsion, where the ovary twists around its supporting ligaments, potentially cutting off blood supply. This is more likely with larger cysts, as their increased weight can make the ovary prone to twisting.
Another concern with larger cysts is the increased risk of rupture, where the cyst breaks open. A ruptured cyst can lead to severe pain and internal bleeding. An 8 cm cyst’s size prompts medical professionals to investigate its characteristics and monitor for potential complications.
Symptoms and Warning Signs
An 8 cm ovarian cyst can cause more pronounced symptoms compared to smaller cysts due to its size. Common symptoms include pelvic pain or pressure, which might be a dull ache or a sharp sensation, often on one side of the lower abdomen. Bloating, a feeling of fullness, or a swollen abdomen are also frequently reported. Some individuals may experience changes in bowel habits, such as difficulty emptying bowels, or increased urinary frequency if the cyst presses on the bladder.
Certain warning signs indicate a medical emergency and require immediate attention. These include sudden, severe abdominal pain, especially if accompanied by nausea or vomiting. Feeling light-headed or dizzy, rapid breathing, or experiencing cold, clammy skin could also signal a serious issue like cyst rupture or ovarian torsion.
Evaluating an 8 cm Ovarian Cyst
An initial step often involves a pelvic ultrasound, which uses sound waves to create images of the ovaries. This imaging helps determine the cyst’s size, location, and characteristics, such as if it is fluid-filled (simple) or contains solid components, septations, or blood flow.
If ultrasound findings are unclear or suggest a complex cyst, other imaging tests like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be used. Blood tests, such as Cancer Antigen 125 (CA-125), can also play a role. While CA-125 levels can be elevated in ovarian cancer, it is not a definitive diagnostic tool, as many non-cancerous conditions can also cause elevated levels. Its utility is higher in postmenopausal women and when combined with imaging findings.
Management and Outlook
For simple, fluid-filled cysts that appear benign on imaging and cause no significant symptoms, a “watchful waiting” approach is often recommended. This involves monitoring the cyst with repeat imaging, typically ultrasound, to see if it resolves on its own. Even large simple cysts up to 10 cm are likely to be benign and may be monitored.
If the cyst is symptomatic, suspicious in appearance, or continues to grow, surgical intervention may be considered. Two surgical options exist: laparoscopy and laparotomy. Laparoscopy is a minimally invasive surgery with small incisions, offering less pain and a quicker recovery. Laparotomy involves a larger incision, typically reserved for very large cysts or those with greater concern. The entire cyst, and sometimes the ovary, may be removed during surgery for further examination.