Benign Ovarian Cysts: Simple Follicle Cysts, Corpus Luteum Cysts, Dermoid Cyst, Fibroma, Fibrotecoma


Benign Ovarian Cysts

Here, you will find the answer for “what should we understand when we hear ovarian cysts”. As a general point of view, you find information about the classifications of various benign ovarian cysts which are already told under separate topics. Hope you enjoy this summary 🙂

Ovaries are organs located in both sides of the uterus in which eggs are grown and feminine hormones are secreted. Each month, a follicle which is an egg inside fluid filled sac develops and when it is maturated, follicle is torn and the egg is thrown. Emptied sac turns into a formation that secretes hormone, which is called “corpus luteum”, and it disappears if pregnancy does not occur.

Ovarian cysts are fluid filled sacs and they are more common in women of reproductive ages. Most of them do not cause any symptoms, they are benign and they disappear spontaneously; a part of them may require surgery, and even be malign.

Most of the ovarian cysts are functional, in other words related to ovulation. Follicle cysts develop when follicle is not torn and the egg inside is not thrown, keeping growing and turning into a cyst. Sometimes they may cause bleeding, pain and torsion, but they usually disappear spontaneously.

Here, you may see MRI image of a follicle cyst. Do not be scared of sizes of these cysts and be operated for nothing.

Prof. Dr. Süleyman Engin Akhan

As an example of non-functional ovarian cysts, endometrioma cysts, dermoid cysts and cystadenomas can be told. Endometriomas are also known as chocolate cysts. Normally, they appear as a result of cells that form the inner layer of uterus being present in the ovaries. Dermoid cysts result from the cells that form the egg cell and they may contain various tissues such as hair, teeth, thyroid gland etc. They may rarely be malign. Cystadenoma derives from the cells on the surface of the ovaries and it may be filled with fluid or mucus. Non-functional ovarian cysts do not disappear spontaneously. Also, some malign ovarian tumors may be in cystic formation.

Ovarian cysts may be asymptomatic and they may be detected during routine gynecological examinations. Some of them cause irregular menstruation, pain or sensation of a mass in lower abdomen or lower back, pain during sexual intercourse or menstruation, frequent urination or trouble urination, sudden onset of abdominal pain, nausea-vomiting and bleeding. In case an ovarian cyst is diagnosed during examination, its location and formation is evaluated with ultrasonography. It may be necessary to measure the levels of tumor indicators (CA 125, CA19-9 etc) in blood or consulting additional imaging methods such as MRI if there is a suspicion of malignity.

Treatment is planned according to age, size of the cyst, its formation and complaints. If a functional cyst is suspected and there is no complaint, it should be followed for 2-3 months. It has been shown that use of oral contraceptives speed up the process of disappearance of these cysts (Cochrane); oral contraceptives may only prevent development of new ovulation related cysts only. At the end of three months, if they do not shrink, they get bigger, cause symptoms and look suspicious, surgery will be considered. Laparoscopic or open surgery is applied; only the cyst may be removed (cystectomy) or the whole ovaries may be necessarily removed.