A cyst is a closed sac filled with liquid, air, or other substances. They can grow anywhere on the body, which includes the ovaries.
Follicular Cysts develop from egg follicles (the parts of the ovaries where eggs form).
Sometimes, eggs fail to develop in their follicles. The follicle can then fill with blood, forming a cyst. Follicular cysts are very common and often induce no symptoms. They tend to disappear of their own accord.
Luteal Cysts develop from the tissue left behind after an egg is released. Sometimes a portion of the tissue can fill with blood, forming a cyst.
Dermoid Cysts develop from the cells used to create eggs. They can occur at a quite young age. They may contain hairs, bone, teeth, and other tissue.
Although this can sound frightening, such cysts are not usually cancerous, so there is no need to panic if you get diagnosed with one. Surgical removal is typically required.
Cystadenomas develop on the outer layers of the ovary. Serous cystadenomas are usually small, but mucinous cystadenomas can grow to be very large.
Although the latter cysts are benign (non-cancerous), they often have to be removed, since they can put pressure on other internal organs.
“Chocolate Cysts” or endometriomas are composed of the endometrial tissue (the tissue that forms the lining of the womb), which grows in the ovary.
Polycystic ovarian syndrome gives multiple small cysts.
The main symptoms of ovarian cysts are pain or bloating in the lower abdomen, discomfort during sexual intercourse, an urge to urinate frequently, menstrual changes, feeling full after eating only a little, nausea, constipation, and fatigue. Not every woman will have every symptom.
When polycystic ovarian syndrome causes cysts, other symptoms such as facial hair growth, acne, and weight gain, are often present.
What Causes Ovarian Cysts
There are various types of ovarian cysts, with different causes.
Follicular cysts (those formed from egg follicles) are very common, but experts still don’t know why some woman get more of them than others.
Risk factors include being overweight and having the first period at a young age. The reasons why luteal cysts (those formed from the tissue left behind when eggs are released) occur are also unknown.
Dermoid cysts (cystic teratomas) form from the cells used to create eggs. It is not clear why some woman get them and not others, although there may be a genetic component since they seem to run in families.
Cystadenomas develop in the outer layers of the ovary. It is not clear why some women get them and not others.
Polycystic ovarian syndrome forms multiple small cysts. The underlying cause is hormone imbalance.
“Chocolate cysts” (endometriomas) are believed to be caused by retrograde menstruation, in which part of the menstrual flow goes up via the fallopian tube towards the ovary.
Endometrial tissue (tissue from the lining of the womb) can be carried towards the ovaries, forming these cysts. Other theories have also been put forward as to why they develop.
Sometimes no treatment is needed, apart from regular monitoring by ultrasound. Many cysts disappear of their own accord.
If the cyst continues to grow, it should get removed. People can take painkillers such as ibuprofen, aspirin, acetaminophen (paracetamol) while medical experts monitor the cyst.
Levonorgestrel-Releasing Intrauterine System (LNG-IUS): This contraceptive device gets placed in the womb. It releases the hormone levonorgestrel.
Thanks to this method periods become much lighter or stop altogether. This device often prevents the pain from an endometrioma.
Progestin hormones, such as medroxyprogesterone acetate, are analogs of the hormone progesterone. They can be taken to minimize the symptoms of endometriomas.
Danazol is a steroid compound used to treat endometriomas. It prevents ovulation and eases the symptoms from endometriomas. “Masculinizing” side-effects, such as hair growth on the face and acne sometimes occur with this drug.
Anti-Androgens, such as spironolactone (Aldactone), reduce the activity of the male hormones and are used to treat the polycystic ovarian syndrome.
They tend to lessen the amount of facial hair. Surgery is used to remove cysts. Laparoscopy, using “keyhole” surgery, can be used to remove reasonably small cysts.
Larger cysts may need full abdominal surgery to remove them. This operation has a longer recovery time than laparoscopy.
If cancer is suspected, doctors usually remove the whole cyst and ovary.
In young women of childbearing age, most cysts do not require any treatment, because they cause few or no symptoms and disappear only after 1 or 2 months.
A reevaluation after the 8-week ultrasound is usually indicated for the physician to evaluate whether the cyst disappeared or increased in size in this interval.
If the cyst is large, generally larger than 5 cm and with continuous growth, cause very intense symptoms, especially if it presents a suspicious appearance in the exams of the image, surgery for removal of the ovarian cyst is an option to be taken into account.
Ovarian cysts caused by endometriosis also usually require surgical treatment.
It is good to note that the size of the cyst is directly related to the possibility of being cancer. Large or growing cysts are not necessarily malignant, just as small cysts are not necessarily benign.
Can ovary cyst be cancer?
Ovarian cancer usually presents as a solid tumor in the ovary, but in some cases, it may look like a cyst.
In women of childbearing age, the ovarian tumor is rare and accounts for less than 1% of ovarian cysts, in fact, a malignant tumor.
In postmenopausal women, most cysts are also benign; However, the occurrence of semi-cystic tumors is higher, requiring a little more attention from the physician.
In most cases, follicular cysts, corpus luteum, endometriomas or dermoid cysts are easily recognizable by ultrasound or magnetic resonance imaging, without much room for confusion with malignant tumors.
However, when it is not possible to rule out cancer through these tests, the cyst should be surgically removed for histopathological evaluation.
Some blood tests, such as the determination of CA 125, help to distinguish malignant tumors from benign cysts because in 80% of cases of ovarian cancer this test is found with increased values.
Therefore, the answer to the previous question is: yes, a cyst may be cancer, but in most cases, it is not.