Health Information

Summary/Definition

Tumors developing in the ovaries can be divided into two categories: malignant, which are cancerous tumors, and benign, which are not oncological in nature. Benign tumors, without posing a threat to life, can cause various symptoms as they increase in size, for example, pain or infertility. In addition, such tumors require regular monitoring, since they can potentially transform into malignant. Benign ovarian tumors are classified according to the type of cells they consist of, and their types may vary depending on the age of the patients. Among the most common benign ovarian tumors at a young age, functional cysts should be distinguished, which occur in 15-20% of women and often disappear on their own without the need for specific treatment. However, in case of suspicion of another cause of the cyst or if the ovarian tumor is solid, it is necessary to conduct an additional medical examination. The exact cause of benign tumors in the ovaries has not yet been established, but like malignant tumors, continuous ovulation and exposure to external factors cause epithelial cells to migrate inside the ovary, forming cysts and increasing the size of the fluid inside the cysts.

Symptoms

If the cyst in the ovary is small, then, as a rule, it does not cause specific symptoms. But if the tumor is very large, the ovary can wrap around the uterus and cause sudden severe abdominal pain. Significant increase in size (diameter from 7 to 8 cm or more) it can cause pressure on the surrounding organs, which leads to a variety of symptoms. Pressure on the anterior organs can cause difficulty urinating, while pressure on the organs in the posterior abdominal region can lead to violations of the act of defecation, for example, constipation. In rare cases, a cyst rupture can lead to abdominal pain or bleeding. In cases of severe outcome, this condition may pose a danger to the patient’s life.

Diagnostics

Since most ovarian tumors manifest themselves without noticeable symptoms, they are usually detected during regular examinations. The most common diagnostic method is ultrasound examination (ultrasound) of the ovaries. In cases where the ovarian tumor is difficult to determine by ultrasound, or there is a suspicion of a malignant tumor, more detailed imaging using computed tomography (CT) or magnetic resonance imaging (MRI) may be required. If a malignant neoplasm is suspected, tests can also be carried out to determine the level of cancer markers in the blood. The exact diagnosis of the type of tumor is usually established by biopsy after its resection.

Gynecological examination plays an important role in the diagnosis of ovarian tumors and includes examination of the external genitalia, vagina, cervix, as well as palpation of the uterus and ovaries. It allows you to identify pain zones and adhesions in the pelvis, and can also be accompanied by examinations of other female organs, for example, a cytological test of the cervix. If the size of the ovarian tumor is small or the patient is obese, palpation of the pelvic organs is difficult and the internal state of the ovary cannot be determined. Ultrasound remains one of the simplest and most accessible methods of ovarian examination, and includes both abdominal ultrasound and vaginal ultrasound. Ultrasound of the abdominal cavity allows you to assess the structure of the abdominal cavity and retroperitoneal space, as well as pelvic organs, but, unlike vaginal ultrasound, it is associated with inconveniences associated with the need to retain urine to fill the bladder, and provides low accuracy when observing the detailed structure of the ovaries. Vaginal ultrasound has high accuracy and is often used at gynecological receptions, as it does not require prolonged retention of urine and provides detailed visualization of the structure of the ovaries. Conducting blood tests, including tests for tumor markers such as CEA, CA 19-9 and CA 125, can also be useful in diagnosis. In case of suspicion of a malignant tumor and the need for a more detailed examination of the abdominal cavity or pelvic organs, CT or MRI may be required.

Treatment and course of the disease

When choosing a treatment method for benign ovarian tumors, it is advisable to take into account several factors, for example, the presence of symptoms, the age of the patient, the size of the tumor and the risk of malignancy. Most benign cystic tumors are small functional cysts that often resolve by themselves and may require only periodic monitoring. In the case of simple functional cysts, taking contraceptives that inhibit ovulation may contribute to a faster disappearance of the tumor. However, if the tumor increases in size or may affect future pregnancy, as well as if the possibility of a malignant neoplasm cannot be excluded, it is surgically removed. In such cases, various surgical methods are used, including open surgery and laparoscopic surgery using endoscopic methods. Laparoscopic surgery has many advantages over open surgery, for example, a shorter period of hospitalization, rapid recovery, fewer complications and smaller surgical wounds, and therefore it is widely used in modern medicine. Even in cases where there is a risk of serious adhesions due to previous operations, for example, cesarean section or appendectomy, open surgery may be a safer alternative compared to laparoscopic surgery.

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