Loading....
Coupon Accepted Successfully!

 

Physiological / Function at Cyst

Type

Description

Presentation

Ultrasound/Cytology

Treatment

Functional Tumors (all benign)

Follicular cyst

• Follicle fails to

rupture during

ovulation

Usually

asymptomatic

 

May rupture,

bleed, tort,

infarct causing

pain ± signs

of peritoneal

irritation

4-8 cm mass,

unilocular, lined with

granulosa cells

• If <6 em, wait 6 weeks then re-
examine as cyst usually regresses
with next cycle

• OCP (ovarian suppression) - will
prevent development of new cysts

• Treatment usually laparoscopic

• Painful, multioculated, or partially solid
masses warrant surgical exploration

Lutein cyst

Corpus luteum

fails to regress

after 14 days,

becoming cystic

or hemorrhagic

More likely to

cause pain than

follicular cyst

May delay onset

of next period

Larger and firmer

than follicular cysts

 

Show a cob web like

appearance

• Same as for follicular cysts

 

Theca-lutein

cyst

Due to atretic

follicles

stimulated by

abnormal p-hCG

levels

Associated with

molar pregnancy,

ovulation

induction with

clomiphene

pregnancy

 

Conservative

Cyst will regress as p-hCG levels fall

Luteoma of

pregnancy

• Usually bilateral

• Due to prolonged

elevation of

Associated

with multiple

pregnancy

 

Same as for theca-lutein

Regresses postpartum

Benign Ovarian Tumors

Benign epithelial tumors = M/C = 80%

  • Serous cystadenoma
  • Mucinous cystadenoma
  • Endometroid cystadenoma
  • Brenner Tumor

Benign sex cord tumors

  • Theca cell tumor
  • Fibroma

Benign germ cell tumors

  • Mature cystic teratoma (dermoid cyst)
  • Mature solid teratoma

Gonadoblastoma
 

Meigs syndrome Combination of fibroma with ascites and hydrothorax, usually right sided is called as Meig's syndrome. Seen in 1 -5% patients.

 

Criteria for diagnosis of Meig's syndrome

  • Tumor must be ovarian, solid and benign.
  • Both hydrothorax and ascites must be present.
  • Removal of the tumour must result in their spontaneous and permanent cure.
     
    Pseudomeig syndrome-When ascites and hydrothorax occur with Brenner, Thecoma and granulosa cell tumor it is called as Pseudomeig syndrome.

Extra Edge: Dermoid cyst:

  • Most common benign tumour of ovary in reproductive age group.
  • Most common benign neoplasm diagnosed during pregnancy.
  • Most common Germ cell tumor.
  • It is the commonest tumor to undergo torsion.

If teeth or bone are seen in X-ray in adnexal mass, it is pathognomic for teratoma.

Complications of Ovarian Cyst

  • Torsion (M/c tumor to undergotorsion - Dermoid cyst Management immediate surgery Detorsion and cystectomy, preserving the ovary)
  • Rupture of cyst (M/c with corpus luteum cyst)
  • Haemorrhage in cyst (M/c with serous cystadenoma)
  • Infection pseudomyxoma peritonei (M/c in muci- nous cystadenoma)
  • Malignancy (risk of malignancy is maximum in - Serous cystadenoma (40%) Least (1 -2%) in Dermoid cyst




Test Your Skills Now!
Take a Quiz now
Reviewer Name