Ovarian cystoma

A true neoplasm that develops from epithelial tissue layers and grows through cell division, affecting the ovary is an ovarian cyst.

Initially, its development is asymptomatic and only over time does a woman begin to feel pathological discomfort. Mostly, this pathology is transformed from a previously formed cyst and can be either a single-chamber or multi-chamber neoplasm, which is located on the so-called anatomical stalk (a set of blood and lymphatic vessels, nerves), the other end of which grows into the affected ovary.

ICD-10 code

According to the International Classification of Diseases, 10th revision (ICD 10), ovarian cystoma has its own individual code - N83, the name of which sounds like "Non-inflammatory lesions of the ovary, fallopian tube and broad ligament of the uterus."

Causes of ovarian cystoma

It is impossible to categorically and unambiguously voice all the sources that provoke the development of the pathology in question today. But a certain circle of women susceptible to this disease can be outlined. Diagnosis of ovarian cystoma, the reasons for its occurrence:

• Ovarian dysfunction.
• History of chronic disease of female genital organs.
• If close female relatives have been diagnosed with ovarian cancer or other female reproductive organs.
• History of surgery involving the ovaries.
• If a woman is a carrier of HPV (human papillomavirus).
• Abortions. The more of them, the higher the risk of injury.
• The woman's medical history included a diagnosis of herpes type 2, that is, genital herpes.
• Amenorrhea is the absence of menstruation for six months or more.
• Irregular menstrual cycle.
• The woman was diagnosed with breast cancer.
• The woman had an ectopic or frozen pregnancy.
• The age of a woman when she approaches perimenopause or menopause.

[ 1 ], [ 2 ]

Causes of right ovarian cystoma

If a cystoma of the right ovary is diagnosed, the gynecologist will not always be able to establish the reasons for its occurrence. But if we consider the anamnesis, it is possible to assume the source of the problem in most cases. The causes of pathology in the development of a cystoma of the right ovary are similar to those voiced above. But we can definitely say that no matter what the impetus was that launched the mechanism of development of the disease, the root cause of the immediate origin of the cystoma is hormonal imbalance and viral infection of the female genital organs (endometritis, colpitis, oophoritis).

[ 3 ], [ 4 ], [ 5 ]

Symptoms of ovarian cystoma

Small neoplasms usually do not affect the menstrual cycle and do not cause discomfort to a woman. At this stage, the pathology can only be detected accidentally during a preventive examination. With further growth of the ovarian cystoma, the symptoms of this pathology gradually begin to appear, increasing in intensity.

These include:

• A nagging pain symptom in the uterine region, radiating to the lumbar and groin areas.
• Bloating, a feeling of distension.
• Infertility.
• Menstrual cycle disorders.
• Frequent urge to go to the toilet to pee.
• Bowel disorder: constipation or, conversely, diarrhea (less common).
• Swelling of the lower extremities.
• In the case of a serous nature of the formation, there is an accumulation of a pale yellow liquid substance in the fallopian tube, and the fluid can also accumulate in other parts of the body.
• In case of twisting of the leg, the pain becomes unbearable, body temperature rises, increased tone of the abdominal muscles and tachycardia are observed.

Trauma or increased physical activity can cause the cyst to rupture.

As a rule, a small cystoma does not manifest itself in any way: the woman feels quite normal, there are no disruptions in the menstrual cycle. It can be diagnosed at this stage of development only during a preventive gynecological examination, or during an examination for suspected infertility.

Only after reaching a certain size can one assume that a woman has an ovarian cystoma, the signs gradually begin to appear and gain intensity. The first thing a woman notices is a nagging, constant pain in the uterus area, which begins to radiate to the lower back and groin area.

The tumor grows and begins to infringe on neighboring organs. Thus, pressure on the bladder manifests itself in frequent urges to urinate, and the intestines may react with constipation (less often diarrhea). Compression of blood vessels leads to swelling of the lower extremities.

With serous cystoma, ascites or hydrosalpinx (obstruction of the fallopian tubes) are sometimes observed. If the capsule stalk is twisted, sharp pain occurs, body temperature rises, increased tone of the abdominal muscles, tachycardia is observed. If the necessary medical care is not provided in a timely manner, cystoma rupture may occur, intoxication of the body, sepsis and death occur.

Serous ovarian cystoma

Based on the substance that fills the capsule, gynecologists divide it into mucinous and serous formations. Serous ovarian cystoma is filled with plasma ultrafiltrate, which is constantly reabsorbed and produced. The inner layer of the cystoma is covered with cells of the superficial or tubular epithelium. The pathology is mainly represented by one chamber, which can reach 30 cm in diameter.

Approximately 10 to 15% of women diagnosed with serous ovarian cystoma are subsequently diagnosed with ovarian cancer if timely measures are not taken. The risk group is women aged 40 to 45 years.

Mucinous ovarian cyst

Mainly, specialists in the field of gynecology have to establish the diagnosis - mucinous ovarian cystoma. This disease has another name - pseudomucinous ovarian cystoma. This neoplasm has an epithelial lining filled with mucous secretion. Mostly, such cystomas have several chambers. This pathology has no age differentiation, although such pathology is still more common in women in the postmenopausal period. Mucinous ovarian cystoma shows an insignificant, only 3 - 5, percentage of degeneration into cancerous tumors.

Multilocular ovarian cystoma

A multi-chamber ovarian cyst is practically no different from a capsule with one chamber. Basically, all the difference comes down to the presence of dividing partitions, which divide the internal space of the cyst into several compartments filled with mucus-like or liquid secretion. The membrane of the neoplasm develops through the division of the epithelial cells of the ovary.

Mostly multilocular ovarian cystoma is a pseudomucinous cystoma.

There are cases when partitions arise due to the fusion of several cysts of different types. The main reason for the formation of multi-chamber capsules is a violation of the hormonal balance in the woman's body.

Cystoma of the right ovary

According to the genesis of its appearance, doctors divide this neoplasm into primary cystoma – proliferating from ovarian tissue cells, and secondary – developing from cancer metastases.

Cystoma of the right ovary is a benign neoplasm subject to high proliferation rate. And if the symptoms are ignored, the disease becomes a "neglected pathology", which provokes the cystoma tissue to degenerate into a malignant tumor. That is, a healthy cell in this situation can go from a benign tumor, through a proliferating one to a malignant one.

The cystoma itself is a capsule with a limited contour, the cavity of which is filled with a substance of liquid or somewhat viscous consistency. The internal lining of the formation is covered with a thin layer of epithelium. Cystoma of the right ovary is most often observed in girls during puberty, as well as in mature women when they enter the period of menopause. This is the peak period when the body of women and girls suffers most from the effects of hormonal imbalance.

Gynecologists distinguish several types of right ovarian cystomas. These are follicular and luteal cystomas, functional genesis, endometrioid, dermoid, as well as pseudomucinous and serous, related to epithelial cystomas. Dermoid neoplasms can be observed in any age category of women, even in a newborn baby, since their occurrence is caused by a failure of embryonic histogenesis.

A cystoma of the right ovary does not arise out of nowhere, but is a consequence of a cyst that has grown in the ovary somewhat earlier.

[ 6 ]

Cystoma of the left ovary

Among tumors affecting female genital organs, obstetricians and gynecologists most often diagnose cystomas. Cystoma of the left ovary, like the right one, is a benign neoplasm characterized by a fairly high proliferation rate. This formation differs from other benign tumors by a high level of risk of malignancy. The development of pathology begins from the epithelial cells of the ovary. In this case, cystoma of the left ovary can reach threatening sizes.

The connecting link with the affected organ is the anatomical pedicle. This small connecting thread includes a system of arteries, lymphatic vessels and nerve ligaments.

Ovarian cystoma during pregnancy

Ovarian cysts are considered true benign tumors, but due to the possibility of degeneration into cancer, they are subject to removal, especially in young women who want to become mothers.

After conception has occurred, the woman's body begins to rebuild itself under the new status, there is a hormonal restructuring, which also affects the following working chain: pituitary gland - hypothalamus - neural system - endocrine system - ovaries. Against the background of reduced immunity, the appearance of neoplasms is quite possible. And if an ovarian cystoma was diagnosed during pregnancy, first of all, the pregnant woman should be under constant medical supervision.

In order not to provoke a miscarriage, the cystoma cannot be excised in the first trimester of pregnancy. The operation can be performed only when the pregnancy moves into the second trimester. If the resection was performed by an experienced surgeon, the fetus is not in danger.

Ovarian cyst size

When getting acquainted with cases of diagnosis of the disease in question, it is striking that ovarian cystoma, the size of which is diagnosed from several millimeters to 10 - 15 cm, can grow and represent quite impressive sizes. This pathology is mainly observed in women over 30 years old. This disease is much less common in representatives of the weaker sex who have already crossed the threshold of 60 years.

Large ovarian cyst

As soon as the conditions that trigger the growth mechanism of pathological neoplasms have developed, the size of the tumor begins to increase rapidly. Not much time passes, and on the computer screen, when a woman undergoes an ultrasound examination, the ultrasound specialist can observe a clearly distinguishable capsule with contents of a lower density than its shell. If earlier an experienced gynecologist could, using the palpation method, state that a large ovarian cystoma is being determined, then modern medical equipment makes it possible to diagnose this disease in its infancy, when the development of the capsule is just beginning and is small in size.

One of the distinctive characteristics of the pathology in question is the rapid proliferative growth of the formed neoplasm. Very little time passes and this capsule, during the next examination, can show dimensions of 10 - 15 cm. But, probably, any gynecologist at least once in his practice had to deal with a special pathology, when a large ovarian cystoma was diagnosed. And these are not isolated cases.

A person is lazy by nature and begins to take countermeasures only when unpleasant discomfort symptoms begin to bother him strongly enough. And if this characteristic feature is superimposed on the Russian "maybe it will pass", then the doctor sometimes has to observe cysts that have reached a diameter of 30 cm. Imagining a ball of such dimensions, an unprepared person can experience a real shock.

But the problem with such neoplasms is not only their terrifying size, but also that the longer it grows, the more likely it is that sooner or later it will malignize into a cancerous tumor. But the problem is not only in the risk of degeneration, a large ovarian cyst takes up more and more space inside the woman's body. This leads to the fact that the neoplasm begins to put pressure on neighboring organs with its weight. Therefore, the clinical picture of an ovarian cyst with large size characteristics is usually accompanied by symptoms indicating malfunctions in, for example, such organs as the intestines, stomach or bladder, and the female genital organs and vascular system also suffer.

Size of the right ovarian cyst

The disease in question is related to polymerizing pathologies. At the same time, their growth rate can be quite significant. If the tumor was not identified in time, then when obvious symptoms appear and the diagnosis is established - cystoma of the right ovary - the capsule size can reach a diameter of up to 30 cm. Such sizes of cystic formation cannot but affect the work of neighboring organs.

But such parameters are rather an exception than a norm. Mostly, cystoma begins to manifest itself much earlier, having reached much smaller sizes.

Ovarian cysts and cystomas

To understand the difference between an ovarian cyst and a cystoma, it is worth understanding what a cyst is and what pathological deviation is called a cystoma.

A cyst is a retention or tumor-like neoplasm of one of the ovaries, filled with fluid or blood. The main impetus for the growth of a cyst is a failure of the woman's hormonal balance, as well as a consequence of a chronic inflammatory process occurring in the organs of the peritoneum and small pelvis. The growth of the neoplasm occurs due to the accumulation of internal secretion.

A cystoma is a true benign formation on the ovary, capable of rapid growth, i.e. the growth of size parameters occurs not due to the accumulation of a larger amount of secretions, but due to the true division of the tumor cells themselves. Cystomas are potentially malignant formations.

[ 7 ], [ 8 ], [ 9 ]

Differential diagnosis of ovarian cystoma

If, during an examination for suspected infertility or in light of a preventive examination, the gynecologist suspects the presence of a tumor in a woman’s medical history, specifically that it is an ovarian cyst, differential diagnostics include:

• Examination of a woman by an obstetrician-gynecologist on the chair.
• Collecting her anamnesis.
• Analysis of patient complaints.

To confirm or refute the doctor’s suspicions, the following is carried out:

• Computed tomography.
• Ultrasound examination of the uterus and ovaries.
• Ultrasound examination of the mammary glands.
• Magnetic resonance imaging (MRI).
• A blood test for tumor markers is also performed.
• A puncture of the abdominal cavity is taken.
• If necessary, an endometrial biopsy is performed.

When determining ovarian cystoma, it should be differentiated from other gynecological diseases with similar symptoms. Therefore, the doctor may additionally prescribe:

• X-ray of the stomach.
• Gastroscopy.
• Consultation with doctors: urologist, proctologist or gastroenterologist.
• In case of doubt, laparoscopy with ovarian biopsy is prescribed, which, if necessary, can develop from a diagnostic procedure into a therapeutic one.

The final diagnosis is obtained only after excision of the neoplasm and receipt of the histological results of its tissues.

[ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ]

The difference between a cyst and an ovarian cystoma

Very often women who are not familiar with medicine do not understand whether there is a difference between an ovarian cyst and cystoma. These two neoplasms are still different.

A cyst is a membrane filled with liquid. Its growth occurs due to the increase in the volume of contents (liquid). Whereas a cystoma is a true tumor that grows due to direct cell division. The percentage of cysts turning into cancerous growths is close to zero, whereas for a cystoma this probability is much higher.

When diagnosing a proliferating epithelial cyst, the gynecologist indicates a precancerous condition in the woman’s diagnosis.

Treatment of ovarian cystoma

The pathology in question can affect one or both ovaries at once. The probability of degeneration of the cells of the formed capsule into a malignant tumor is quite high. At the same time, statistics of clinical observations indicate that, for example, a mucinous cystoma shows a malignancy rate of 5%, while a serous neoplasm shows a malignancy rate of 15%.

Based on the above, if an ovarian cystoma is diagnosed, the treatment of this pathology is reduced to the only possible method - surgical removal of the cystoma. If the pathology is found in a young woman, then she undergoes a cystectomy. This is a surgical, very unpredictable, intervention, in which the obstetrician-gynecologist removes only the cystoma, healthy ovarian tissues of the ovary are preserved intact, and within the healthy tissue, the sprouted capsule cells are carefully enucleated.

After this operation, the specialist will definitely prescribe a study on tumor markers, the so-called specific substances that are products of the vital activity of cancerous tissues or are compounds produced by healthy cells in response to the invasion of malignant elements. To conduct this study, the patient's blood and urine are taken for analysis.

But there are clinical indications when the surgeon has to excise not only the pathological growth, but also the affected ovary. This procedure is mainly performed laparotomically (surgical opening of the abdominal cavity, the incision is made along the lower line of the abdomen) or laparoscopically (a low-traumatic method of performing surgical operations, performed using a laparoscope).

If the tumor marker test is positive or dynamic monitoring of the cystoma shows its very active growth, in such a situation the doctor may prescribe radiation or chemotherapy. This will prevent or treat the development of cancer in its infancy.

In general, if a woman has undergone a cystectomy in a timely manner, her prognosis for the future is quite favorable, up to a complete recovery. However, such patients need to be regularly examined by a gynecologist - oncologist. This preventive operation is much more gentle on the woman's body than the measures that will have to be taken in case of the need to stop the results of complications of this disease.

Preventive measures include properly selected contraceptives, regular visits to the gynecologist, and periodic ultrasound examinations.

Removal of ovarian cystoma

Regardless of the clinical picture and size parameters of the neoplasm, a woman diagnosed with ovarian cystoma is definitely shown removal of the pathological formation, possibly together with the affected ovary. The main reason for such a radical method of treatment is the high risk of malignancy of the cystoma, as well as its rapid growth, which negatively affects the functioning of other pelvic organs.

After the diagnosis of ovarian cystoma is established, the removal and accompanying studies are carried out by a gynecologist-oncologist. After excision, the obtained material is sent to the laboratory for further examination, during which the nature of the capsule is clarified and an answer is given on the presence or absence of cancer cells in the excised tissues.

The volume of the intervention is determined by the size of the capsule, its physical and chemical parameters, which are determined using intraoperative histological examination, as well as the patient's age and the woman's plans to have a child or not in the future. Most often, a woman is prescribed laparotomy or laparoscopy. The question of prescribing one or another method of surgical intervention is decided by the surgeon-gynecologist individually in each case.

In a clinical picture where a young woman is diagnosed with a smooth-walled serous cystoma, not burdened by the onco-alert factor, the doctor usually prescribes a cystectomy, a gentle surgical intervention method that makes it possible to resect the pathology while preserving the ovarian tissue.

If a woman of reproductive age is diagnosed with mucinous, papillary-serous cystoma, then the attending physician will have to prescribe the patient a laparotomy with complete removal of the affected ovary. If the woman has already left the reproductive period, then she will most likely be prescribed a panhysterectomy (an operation in which the uterus and appendages are removed). Such a radical method of treatment will protect the woman in the present and in the future from cancer of the genital organs.

An obstetrician-gynecologist may resort to emergency surgical intervention if an ultrasound examination has shown that the cystoma stalk is twisted, as well as when the cystoma capsule has burst and its contents have leaked inside. Delay is unacceptable. Any delay can lead to intoxication of the body, sepsis and death.

If cancer cells are found in the neoplasm, or if its characteristics are borderline, the doctor has the right to prescribe radiation, hormonal or chemotherapy.

Ovarian cyst removal surgery

Ovarian cyst removal surgery is mainly performed using the endoscopic method. The essence of the method is that the doctor makes three holes in the anterior abdominal surface in certain places, through which the pathological tissue is excised using a laser. The positive characteristics of this method include the absence of scars and discomfort in the postoperative period, a low level of trauma, and a short recovery period. The negative characteristics are that not every medical institution has the equipment to perform this procedure. Therefore, the most commonly used method is electrocoagulation (cauterization of soft tissues with electric current).

Laparoscopic excision of the flesh is often used - it is similar to the endoscopic method and is performed under general anesthesia. The first stage of this operation is filling the abdominal cavity with gases, after which the capsule is removed through one of the punctures. Thanks to the use of high-precision optical equipment, it is possible to avoid standard complications that classical laparotomy gives, for example, colloid scars, which is important if the woman is still planning to become a mother.

There are indications when laparotomy or abdominal surgery is unavoidable. Then the abdominal incision is significant, a scar is formed, and the recovery period takes longer.

The main parameters on the basis of which the doctor makes a choice of the method of excision of the cyst are the type and size of the tumor, the health of the woman, the equipment of the medical institution and the level of qualification of its personnel, as well as the risk of developing various complications.

The preoperative period includes abstaining from food, smoking and drinking on the day of the planned operation. Immediately before the procedure, the patient is given a drug that should prevent the formation of blood clots.

Treatment of right ovarian cystoma

For such a pathology as a cystoma of the right ovary, there is only one treatment - surgical intervention with the removal of the pathological tumor. And the faster this procedure is carried out, the fewer complications and pathological changes the woman's body will receive. But the methods of excision are somewhat different. And which method to use in a particular case is decided by the attending physician - gynecologist. He can do this only after the general picture of the disease is obtained.

For example, in the case of a serous cystoma, only the capsule itself is resected, whereas in the case of a mucinous tumor, the capsule is removed together with the affected ovary. After which the excised tissues are subjected to a thorough examination to detect the cancer cells themselves or antibodies to them. In case of a positive answer, the gynecologist-oncologist prescribes laser and chemotherapy to the patient.

But even if the results of the biochemical analysis for tumor markers are negative, it is advisable for the patient to undergo examination by an oncologist-gynecologist twice a year, since a woman who has undergone such an operation automatically falls into the risk group for oncology.

Surgery for right ovarian cystoma

If a cystoma of the right ovary is diagnosed during a routine or emergency examination, the operation is definitely performed. The direct method and volume of the intervention is determined by the attending physician - gynecologist or gynecologist - oncologist strictly individually, based on the factors that make up the full clinical picture of the disease, which were described above.

In case of right ovarian cystoma, surgery is prescribed without delay, since complications of this pathology include hemorrhage, malignancy, perforation of the pathological neoplasm, tissue necrosis, pressure on adjacent organs and body systems, twisting of the capsule stalk. The prognosis is assessed based on the results of the histological structure of the formation.

Treatment of left ovarian cystoma

For such a pathology as a cystoma of the left ovary, treatment, as in the case of damage to the right ovary, there is only one - surgical intervention with the removal of the pathological tumor. The faster the operation is performed, the fewer complications and pathological changes the woman's body will receive.

All methods of removing the neoplasm and the factors influencing their choice are similar to those already discussed in the case of therapy when diagnosing a cyst on a woman’s right ovary.

The main objective of the operation:

• Confirmation of the disease.
• Determining the nature of the cyst.
• Exclusion of cancer pathology.
• Excision of the neoplasm.
• Gentle treatment of healthy adjacent tissues.

Surgery for left ovarian cystoma

In the vast majority of cases, when diagnosing a left ovarian cystoma, surgery is the only method of therapy considered by the gynecologist. He is faced with the only question of determining the method by which the neoplasm is removed. The choice is mainly between laparotomy or laparoscopy. The main factors that tip the scales toward one or the other method are similar to the choice when operating on a right ovarian cystoma.

The volume of excision depends on the size of the formation, the nature of the tumor, which is determined by histological examination, as well as the age of the patient and her desire to become a mother in the future.

Laparoscopy of ovarian cystoma

Quite often, laparoscopy of ovarian cystoma is prescribed as a surgical intervention method. The preparatory stage for this procedure is similar to the period before preparation for other endoscopic methods. The "operation" itself is performed using general anesthesia. On average, the entire procedure takes from half to one and a half hours.

The surgeon makes one small incision below the navel, through which the videoscope is inserted. A little lower and spaced apart along different stolons, two more incisions are made. A special instrument necessary for excision is inserted through them to the resection site. Monitoring his work through the eyepiece of the videoscope, he makes an incision on the cystoma with the instrument and gradually removes it.

The procedure is not complicated, but effective.

Treatment of ovarian cystoma with folk remedies

A cystoma is a benign tumor that can subsequently degenerate into cancer. If the tumor is small, there is a chance to get rid of it using grandma's methods. You can include one of the recipes below in the treatment of ovarian cystoma using folk remedies.

1. Steep a tablespoon of dry silverweed in boiled milk or water for a couple of hours. Drink half an hour before meals three times a day.
2. A decoction of this plant will also do. Just boil the grass for a quarter of an hour over low heat, then let it brew for two hours, strain. You need to drink a quarter of a glass three to four times a day.
3. Chamomile taken in equal proportions with lemon balm has proven itself to be excellent. Pour this mixture with just boiled water and let it stand for four hours. Drink it hot.
4. Pour three tablespoons of corn silk with a glass of boiling water and boil for 10 minutes on low heat. Strain and drink 50 g three times a day.
5. Take one tablespoon of calendula, celandine and chamomile. This collection is poured with half a liter of boiling water, and the container is well wrapped in a warm blanket for the whole night. Drink the resulting infusion three times during the day half an hour before meals in a dose of half a glass.
6. A decoction of alchemilla made with grape wine is suitable as a douche.

Our great-grandfathers advised starting treatment with folk remedies in the first phase of the lunar calendar. They believed that in this case the therapy would be more effective.

Treatment of ovarian cystoma without surgery

Mostly, when a diagnosis of ovarian cystoma treatment is made, it is almost impossible to do without surgery. Only if such a neoplasm was detected at an early stage of development and is small in size, you can try to conduct resorption drug therapy or use traditional medicine recipes.

It is worth remembering that when undergoing such treatment, the patient must be constantly under the supervision of a doctor, undergoing periodic diagnostics to determine the size of the capsule. If regression does not occur and the cystoma continues to grow rapidly, it will not be possible to avoid surgical intervention.

To sum up the above, we can state that ovarian cystoma is not only an uncomfortable disease, but also a dangerous one. Therefore, a woman can avoid this pathology or get out of the fight against the disease with the least losses to her health only by regularly visiting a gynecologist, not ignoring his preventive examinations and ultrasound examinations. A woman should take care of her health in terms of excluding abortions, injuries, and preventing infectious and inflammatory diseases.

You just need to be more attentive to the signals of your body and seek help from a specialist in time!