OVARIAN CYSTS?
“Cyst” is a term used for a structure that is filled with fluid and which may or may not represent a tumour. Many times cysts form in one or both ovaries. They may vary in size from few millimetres to many centimetres, sometimes filing the entire abdomen. They may be single or multiple, may be present in one or both the ovaries, may be benign or malignant, may cause symptoms or may be entirely asymptomatic and may be just diagnosed by chance.
Common types of ovarian cysts seen in the gynaecological practice.
·Physiological cysts
·Follicular cysts
·Simple benign ovarian cysts
·Germ cell ovarian tumours
·Endometriotic cysts
·Polycystic ovary
·Malignant ovarian cysts
Common Symptoms
·No symptoms,
·Weight gain or weight loss
·Heaviness, Pain or dull ache in abdomen
·Loss of appetite
·Menstrual disturbances like absent, scanty, irregular periods
·Painful periods
·Pain during sexual intercourse, painful bowel movements
·Pressure symptoms on the neighbouring structures
Investigations done to diagnose ovarian cyst:
·Ultrasound
·Computed Tomography (CT)
·Magnetic Resonance Imaging (MRI)
Role of Tumour Markers
Tumour markers are chemicals which are found in the blood, urine or some tissues of patients with certain types of ovarian cysts. They are typically produced by the tumour cells while in some cases they may be produced by the body in response to malignancy or some benign tumours. These tumour markers may not be elevated in all types of ovarian cysts specially with an early disease. These markers are often used for screening, diagnosis, prognosis, assessing therapeutic response and detecting recurrences.
Common ovarian tumour markers -FSH, LH, beta HCG, AFP, CA-125, HE4, Inhibin, CEA, SCC antigen, Mullerian inhibiting substance (MIS), carbohydrate antigen19-9, cancer antigen 27-29, Human Telomerase reverse transcriptase (hTERT)
Treatment
The treatment for the ovarian cyst is entirely individualized based on the patient’s age, history, symptoms, signs, findings and the investigation reports. The treatment modalities could be simple observation / conservative management, medical treatment ( progestogens / cyclical pills / GnRh agonists / Danazol ), surgical treatment ( ovarian cystectomy, oophorectomy or radical surgery if indicated.
Dr Radha Rao is a gynaecologist of repute in South Bangalore with vast and rich experience in treating all kinds of gynaecological ailments. She is a skilled laparoscopic surgeon, trained at the best institutes. A patient diagnosed with an ovarian cyst is first thoroughly examined by her. All treatment modalities including medical managements, conservative observational approach and surgical treatments are discussed in detail with the patient and family if required.