An adnexal cyst is a fluid-filled sac that develops in the adnexa, which refers to the structures located adjacent to the uterus. These structures primarily include the ovaries and fallopian tubes. Such cysts are a common occurrence and are frequently benign, meaning they are not cancerous.
Understanding the Adnexa
The adnexa comprises the anatomical structures closely associated with the uterus, forming a significant part of the female reproductive system. This region primarily encompasses the ovaries and the fallopian tubes. Supporting ligaments also form part of the adnexa, helping to maintain the position of these organs. Understanding this specific anatomical location clarifies that an adnexal cyst is a growth found within or on these particular reproductive components.
Common Types of Adnexal Cysts
Adnexal cysts encompass various types, broadly categorized into functional and pathological forms. Functional cysts are the most common and typically relate to the menstrual cycle. Follicular cysts, for instance, arise when a follicle on the ovary grows but fails to release an egg. Corpus luteum cysts form if the corpus luteum, a structure that develops after ovulation, continues to grow instead of breaking down. These functional cysts are usually temporary and resolve on their own.
Beyond functional cysts, several pathological types can occur. Dermoid cysts, also known as mature teratomas, contain various tissues such as skin, hair, and sometimes even bone or teeth. Endometriomas, often called “chocolate cysts,” are linked to endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, forming cysts filled with old blood.
Cystadenomas are another type, originating from the surface of the ovary, and can be filled with either clear (serous) or thick, sticky (mucinous) fluid. Additionally, a hydrosalpinx is a fluid-filled blockage within a fallopian tube. While most adnexal cysts are benign, a small percentage can be malignant.
Recognizing Symptoms
Adnexal cysts often do not produce any noticeable symptoms, being discovered incidentally during routine medical examinations. When symptoms do occur, they can include pelvic pain, which may manifest as a dull ache, sharp pain, or intermittent discomfort. Individuals might also experience a feeling of pressure or bloating in the abdomen. Changes in bowel habits, such as constipation, or increased urination frequency can also be associated with adnexal cysts. Pain during sexual intercourse is another possible symptom.
Certain signs necessitate immediate medical attention. These warning signs include sudden, severe pelvic or abdominal pain, especially if accompanied by fever, nausea, or vomiting. Dizziness or lightheadedness are also indicators, as these symptoms could suggest a cyst rupture or ovarian torsion, where the ovary twists on its blood supply.
Diagnosis and Management
The diagnosis of an adnexal cyst typically begins with a pelvic exam. Imaging techniques are then employed, with ultrasound being the primary tool for visualizing these structures. Further evaluation might involve magnetic resonance imaging (MRI) or computed tomography (CT) scans if more detailed information is needed. Blood tests, such as CA-125, may also be performed, though it is important to note that CA-125 levels can be elevated due to various benign conditions and are not a definitive cancer marker.
Management of adnexal cysts varies depending on factors like the cyst’s type, size, and symptoms, as well as the patient’s age and overall health. For small, asymptomatic cysts that are likely benign, a “watchful waiting” approach is often adopted, involving follow-up ultrasounds. Hormonal contraceptives may be prescribed for functional cysts to help prevent the formation of new ones. Surgical intervention becomes necessary if a cyst is large, causing persistent symptoms, appears suspicious for malignancy, or if complications like torsion occur. Surgical options range from minimally invasive procedures like laparoscopy to open surgery.