Ovarian Cysts

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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How are ovarian cysts treated?

Most ovarian cysts in women of childbearing age are follicular or corpus luteum cysts (functional cysts) that disappear naturally in one to three months, although they can rupture and cause pain. They are benign and have no long-term medical consequence. They may be diagnosed coincidentally during a pelvic examination in women who do not have any related symptoms. All women have follicular cysts at some point that generally go unnoticed.

Ultrasound is useful to determine if the cyst is simple (just fluid with no solid tissue, suggesting a benign condition) or compound (with solid components that often requires surgical resection).

In summary, the ideal treatment of ovarian cysts depends on what the cyst is likely to be. The woman's age, the size (and any change in size) of the cyst, and the cyst's appearance on ultrasound help determine the treatment. Cysts that are functional are usually observed unless they rupture and cause significant bleeding, in which case, surgical treatment is required. Benign and malignant tumors require operation.

Treatment can consist of simple observation, or it can involve evaluating blood tests such as a CA-125 to help determine the potential for cancer (keeping in mind the many limitations of CA-125 testing described above).

The tumor can be surgically removed either with laparoscopy,, or if needed, an open abdominal incision (laparotomy) if it is causing severe pain, not resolving, or if it is suspicious in any way. Once the cyst is removed, the growth is sent to a pathologist who examines the tissue under a microscope to make the final diagnosis as to the type of cyst present.

What are the risks of ovarian cysts during pregnancy?

Ovarian cysts are sometimes discovered during pregnancy. In most cases, they are an incidental finding at the time of routine prenatal ultrasound screening. The majority of ovarian cysts found during pregnancy are benign conditions that do not require surgical intervention. However, surgery may be indicated if there is a suspicion of malignancy, if an acute complication such as rupture or torsion (twisting of the cyst, disrupting the blood supply) develops, or if the size of the cyst is likely to present problems with the pregnancy.

Medically reviewed by Steven Nelson, MD; Board Certified Obstetrics and Gynecology

REFERENCE: eMedicine.com. Ovarian Cysts.
<http://emedicine.medscape.com/article/255865-overview>

Medically Reviewed by a Doctor on 2/4/2015

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