Benign (non-cancerous) ovarian masses are very common. Everyone has heard horror stories about malignant ovarian masses (ovarian cancer), but it is important to note that most masses in the ovaries are not cancerous.
Benign ovarian masses are commonly seen in women of child-bearing age and may be due to physiologic cysts (fluid filled sacs) or benign tumors. This article will focus on the former.
Many of these masses are incidental findings seen on tests done for other reasons and have no clinical significance. However, in some cases these masses should be followed and further tests may be warranted to rule out a more serious condition.
Physiologic cysts are among the most common benign ovarian disorders. It is often appropriate to simply reevaluate them in approximately 6 weeks and if they have not shrunk (or if they have grown), further evaluation may be warranted, especially if they have concerning features on ultrasound.
A laparoscopy is a common surgical procedure done to evaluate such a mass. It entails inserting a thin instrument with a camera lens on the end (a laparoscope) thru the skin and muscles of the pelvic wall to literally examine the internal organs without actually opening up the patient. On the other hand, a laparotomy is a more detailed surgical procedure in which the surgeon does make an incision and open up the abdominal/pelvic cavity to take a look around. If a cyst is found, a cystectomy (removal of the cyst) can be performed and the ovary left intact.
Types of Physiologic Cysts
Follicular cysts are quite common and may range in size from 1 to 3+ inches. They result from a failure in ovulation duration the cycle. This occasionally occurs in many women and may be due to a disturbance in the release of a hormone from the brain. This does not signal any type of disease. It is simply an occasion fluctuation in hormonal balance that many perfectly healthy women experience from time to time.
Follicular cysts frequently cause no symptoms, though in some cases they may cause bleeding, pelvic pain, or painful intercourse. Most follicular cysts resolve on their own within a couple of months with no treatment at all.
Corpus luteum cysts are another type of benign ovarian cyst. They typically range in size from 1 to 4+ inches. These cysts may result when there is an aberration in the normal physiologic processes of a menstrual cycle, though, like with follicular cysts, they are also seen in healthy women and their presence does not signify any disease process. These cysts can cause pain or soreness in the pelvic area overlying the cysts. They may also cause menstrual abnormalities, such as a late cycle or missed periods. Corpus luteum cysts, like follicular cysts typically resolve within several weeks.
Theca lutein cysts are related to elevation in the levels of the hormone chorionic gonadotropin and may be seen in women taking fertility treatment with the medication clomiphene, in a normal pregnancy, or in potentially more serious conditions. They too may cause pelvic discomfort. However, these cysts are not very common.
If you are diagnosed with a pelvic mass, do not panic. Countless women have ovarian cysts, whether documented or not. Talk with our doctor to get a better understanding of the potential clinical significance, if any, and don?t forget to follow through on the advice your doctor recommends.
[Polycystic ovarian syndrome (Stein-Leventhal Syndrome) is a much more complicated disorder and will be covered in detail in a subsequent article dedicated to this condition.]
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