Ovarian serous cystadenoma is a common benign, non-cancerous ovarian tumor that occurs on the ovary. It is a fluid-filled sac, often discovered during routine examinations or when investigating other symptoms.
What is Ovarian Serous Cystadenoma
Ovarian serous cystadenomas are a common type of epithelial tumor, originating from the surface of the ovary. They are distinct from other ovarian cysts, such as functional cysts or mucinous cystadenomas, because they are filled with a thin, watery fluid, known as serous fluid. They are also unilocular, meaning they have a single chamber, though they can sometimes be multilocular.
These cystadenomas can vary in size, ranging from 1 centimeter to over 30 centimeters in greatest dimension, with an average diameter of about 10 centimeters. They are the most common type of benign ovarian tumor, accounting for 50-80% of all benign epithelial ovarian tumors. While they can occur in adults of all ages, their prevalence tends to peak between 60 and 70 years of age, with a higher incidence observed in postmenopausal women.
Common Symptoms and Risk Factors
Many ovarian serous cystadenomas do not cause symptoms, particularly when small. These asymptomatic cysts are found incidentally during imaging studies, such as a routine transvaginal ultrasound examination. When symptoms arise, they are related to the cyst’s size or the pressure it exerts on surrounding organs.
Common symptoms can include pelvic pain or pressure, a feeling of bloating, or a sensation of fullness in the abdomen. Some individuals may also experience frequent urination or changes in bowel habits due to the cyst pressing on the bladder or intestines. There are no clear risk factors for developing ovarian serous cystadenomas, as they are a common occurrence.
How Ovarian Serous Cystadenoma is Diagnosed
The initial detection of an ovarian serous cystadenoma occurs during a routine pelvic examination. Diagnostic imaging techniques are then employed to evaluate any suspected masses. Transvaginal ultrasound is the first-line imaging modality, providing detailed images of the ovaries. Doctors look for specific characteristics such as a unilocular cyst with a thin wall, anechoic or hypoechoic content, and a smooth inner lining, without significant vascularity on Doppler imaging.
In some cases, an abdominal ultrasound, MRI, or CT scan may be used for a more detailed evaluation or to differentiate the cyst from other conditions. While blood tests like CA-125 can be performed, elevated CA-125 levels are not specific to ovarian serous cystadenomas and can be raised by many benign conditions, including other benign cysts. The definitive diagnosis of an ovarian serous cystadenoma requires a histopathological examination of the tissue after surgical removal.
Treatment Options
Treatment for ovarian serous cystadenomas is individualized, considering factors such as the cyst’s size, the presence and severity of symptoms, the patient’s age, and their desire for future fertility. For small, asymptomatic cysts, a conservative management approach known as watchful waiting may be recommended. This involves regular monitoring with follow-up scans to observe any changes in the cyst’s size or characteristics.
When surgical intervention is necessary, there are generally two main approaches: laparoscopy and laparotomy. Laparoscopy is a minimally invasive procedure involving small incisions, while laparotomy is an open surgery requiring a larger incision. The choice between these depends on the cyst’s size, complexity, and other patient-specific factors. During surgery, either a cystectomy, which removes only the cyst while preserving the ovary, or an oophorectomy, which is the removal of the entire ovary, may be performed. The decision to preserve the ovary often depends on the patient’s age and desire to maintain fertility. The primary goal of surgical treatment is to remove the growth and confirm its benign nature through pathological examination.
Prognosis and Monitoring
The prognosis for individuals diagnosed with benign ovarian serous cystadenomas is generally excellent once the growth has been removed. These tumors are non-cancerous and typically do not pose a serious health risk. The likelihood of recurrence for benign serous cystadenomas after removal is considered low.
Following treatment, follow-up appointments and monitoring are important, as advised by healthcare providers, which may include further ultrasound examinations. While rare, a serous cystadenoma could be associated with a borderline tumor or carcinoma, but for a confirmed benign diagnosis, this transformation is uncommon.