Types of cystadenomas
The tumor grows from the surface epithelium of the ovary and is divided into several types based on the structure of the contents. Serous cystadenoma contains a clear fluid, usually unilocular, with a smooth internal surface. Mucinous is filled with thick mucus, often multi-chambered and can reach very large sizes. Separately, there are papillary forms that have papillary growths on the wall: they require more careful attention, as they are often associated with a risk of malignancy. They all differ from functional cysts in the presence of a true epithelial lining.
- Serous cystadenoma
- Mucinous cystadenoma
- Papillary form with growths on the wall
- Borderline tumor - intermediate option
- Difference from follicular cyst and corpus luteum cyst
Symptoms
Small formations are asymptomatic and are detected by preventive ultrasound. When the tumor reaches several centimeters, pulling sensations and heaviness appear in the lower abdomen, often on one side, discomfort during physical activity and sexual intercourse. Large mucinous cystadenomas increase the volume of the abdomen and put pressure on the bladder and rectum, causing frequent urination and constipation. The cycle is usually not disrupted - this is an important detail that distinguishes cystadenoma from hormonally active formations and endometrioid cysts.
- Most often there are no complaints
- Heaviness and nagging pain in the lower abdomen on one side
- Increased abdominal volume
- Frequent urination
- Constipation and rectal pressure
- Discomfort during sexual intercourse
- The cycle usually does not change
Why is it dangerous?
The main risk is not related to the very existence of the tumor, but to complications. Torsion of the pedicle of the formation disrupts the blood supply and requires emergency surgery: severe pain, nausea, vomiting occurs, and the condition quickly worsens. Rupture of the capsule is accompanied by pain and bleeding into the abdominal cavity. Large mucinous tumors, when ruptured, can spread mucous contents throughout the peritoneum. A separate task is not to miss a malignant or borderline tumor, which may look similar on ultrasound, especially in the presence of papillary growths.
- Torsion of tumor pedicle
- Capsular rupture and bleeding
- Suppuration of contents
- Compression of neighboring organs
- Borderline and malignant variants
- Difficulty conceiving with large formations
Survey
The main method is transvaginal ultrasound examination with assessment of the structure of the formation: size, number of chambers, thickness of the septa, presence of growths and blood flow. The doctor focuses on standard ultrasound signs that separate benign and suspicious formations. The CA-125 tumor marker is used as an addition, remembering that it increases with endometriosis, inflammation and even during menstruation, and in young women it is often uninformative. If the picture is unclear, an MRI of the pelvis is prescribed. The final answer is given by histological examination of the removed tumor.
- Transvaginal ultrasound with blood flow assessment
- Repeat ultrasound after 1–2 cycles to distinguish from a functional cyst
- CA-125 tumor markers and additional indicators
- MRI of the pelvic organs if in doubt
- Examination by a gynecologist and evaluation of complaints
- Histological examination after removal
Treatment
There is no conservative treatment for cystadenoma: neither hormonal drugs, nor physiotherapy, nor herbs will make it disappear. The main method is surgical removal, most often laparoscopic, with maximum preservation of healthy ovarian tissue. In young women, they strive to remove only the formation within the capsule. In menopause, in case of large sizes or suspicious signs, the scope of the operation is expanded, sometimes removing appendages. The removed material must be sent for histology. Observational tactics are permissible only for small asymptomatic formations according to the doctor’s decision.
- Laparoscopic removal of formation
- Preservation of ovarian tissue in women of reproductive age
- Removal of appendages for suspicious signs or menopause
- Emergency surgery for torsion and rupture
- Urgent histological examination for suspected tumor
- Observation with ultrasound for small asymptomatic formations
- Planning pregnancy after surgery is discussed with your doctor
