What Is a Complex Ovarian Cyst?

Ovarian tumors are common tumors of female genitalia, and they have a variety of different properties and morphologies, namely unilateral or bilateral, cystic or solid, benign or malignant. Among them, cystic is more common, with a certain proportion of malignant.

Basic Information

English name: ovarian cyst
Visiting department: Obstetrics and Gynecology

Multiple groups: 20-50 years old female
Common causes: Related to genetic, endocrine, environmental and other factors
Common symptoms: Mobility, no tenderness, intramedullary mass

Causes of ovarian cysts

Genetic factor

According to statistics, 20% to 25% of patients with ovarian tumors have a family history.

2. Endocrine factors

The ovary is an important organ for ovulation and secretion of gonadotropins. Ovarian tumors mostly occur at the reproductive age. Clinically, the basic pathophysiological change of many patients with ovarian cysts and patients with polycystic ovary syndrome is that the ovaries produce too much androgen, and the excessive production of androgens is the result of the synergistic effects of various endocrine system functions in the body.

3. Lifestyle factors

Long-term diet structure, poor living habits, and excessive psychological stress can cause physiological ovarian cysts and true ovarian masses.

4. Environmental factors

Food contamination, such as vegetable growth hormones used in vegetables, and hormones such as lean meat in formulas and livestock. In recent years, with the improvement of living standards and changes in dietary habits, and the abuse of hormone drugs and tonics by some young and middle-aged women, such as breast enhancement, weight loss, and slowing of aging, ovarian tumors have a high incidence and a tendency to become younger. May be relevant.

Clinical manifestations of ovarian cysts

Intra-abdominal masses of medium to large size, if there are no complications or malignant changes, their greatest feature is mobility, which can often move from the pelvis to the abdominal cavity. Malignant or inflammatory conditions, limited mass movement, tenderness, and even peritoneal irritation and ascites.

Ovarian cyst examination

Color Doppler ultrasound, MRI, CT, serum tumor markers, etc., and the application of laparotomy, laparoscopy, laparotomy, etc. in special cases.

Ultrasound examination

Ultrasound is the easiest way to check for ovarian cysts. Ultrasound can show ovarian enlargement and tenderness on the affected side.

2. Laparoscopy

The general condition of the tumor can be seen directly, the entire pelvic abdomen can be observed, multi-point biopsy at the suspicious site and absorption of ascites fluid for cytology can confirm the diagnosis and postoperative monitoring. However, it is contraindicated in patients with large masses or adhesive masses, and retroperitoneal lymph nodes cannot be observed.

3. Radiological diagnosis

MRI and CT are helpful for the diagnosis of metastases such as tumor liver, lung and retroperitoneal lymph nodes. Abdominal plain film is helpful for the diagnosis of intestinal obstruction.

4. Other

If the cyst is a malignant ovarian tumor, like other tumors, it can produce and release a variety of products such as antigens, hormones and enzymes. These substances can be detected in patients' serum by immunological, biochemical and other methods, called tumor markers. It suggests that there is some tumor in the body.

(1) CA125 is a tumor marker that is sensitive to ovarian tumors. AFP is the best tumor marker for endodermal sinus tumor. The immature teratoma AFP value can also be increased. AFP usually rises before clinical signs. It is of great significance in diagnosis and monitoring.

(2) Hormone markers The chorionic gonadotropin beta subunit (-hCG) is a highly specific marker of gestational trophoblastic disease. Serum concentrations in ovarian choriocarcinoma patients also tend to increase. Patients with granular cell tumors and follicular membrane cell tumors have increased estrogen levels. Urinary 17-ketosteroid excretion increased in 30% of patients with testicular blastoma.

(3) The enzymatic marker / lactate dehydrogenase (LDH) increased in patients with ovarian cancer.

Ovarian cyst diagnosis

The diagnosis of ovarian cysts often differs depending on the size and characteristics of the tumor. When inquiring about the medical history in detail, not only pay attention to the reproductive organs, but also pay attention to the general medical conditions and other important organs' related medical history; combining clinical manifestations and physical examination, in addition to paying attention to tumor In addition to its own characteristics, it is necessary to understand the general situation, so not only gynecological examinations, but also body examinations, especially abdominal examinations, are also very important. If necessary, with the help of other auxiliary diagnostic methods, combined with a comprehensive analysis of the medical history, we can get a correct diagnosis.

Patients with ovarian cysts may have a history of abdominal mass. Through abdominal palpation and double joint diagnosis, the boundary and activity of the uterus and the mass can generally be determined.

Ovarian Cyst Treatment

Surgical treatment: The treatment of ovarian cysts depends on the patient's age, whether it is malignant, the location, volume, size, growth rate of cysts, whether to retain fertility, and the subjective wishes of the patient.

1. Surgical treatment of benign ovarian cysts

(1) Ovarian cystectomy, young patients, especially premenopausal patients, mostly use this method, while retaining normal ovarian tissue as much as possible.

(2) Salpingo-oophorectomy. For older (45+ years) or postmenopausal patients, one or both salpingo-oophorectomy may be performed.

2. Surgical treatment of malignant ovarian cyst

(1) Most patients have reached the advanced stage at the time of consultation, so every effort should be made to remove the primary cyst and the pelvic and abdominal metastases that can be seen.

(2) Indwelling catheters in the abdominal cavity may be considered for postoperative intraperitoneal injection of chemotherapy drugs.