Ovarian cysts are a widespread disease in women of childbearing age. At the same time, 30% of cases of cyst formation are diagnosed in patients with a regular menstrual cycle and 50% with a disrupted one. During menopause, the disease can occur in 6% of women.
Types of ovarian cysts
By their nature, cysts are divided into functional and organic. The first ones are temporary and are formed due to a minor malfunction of the ovary. A functional cyst is usually treated with oral hormonal drugs and self-destructs after one to two months. But there are also cysts that do not disappear for more than two months and require surgical intervention. They are commonly called organic.
Follicular. The cavity of the follicular cyst has thin walls with a smooth surface, with a diameter of two to seven centimeters. Sometimes several follicular cysts can form along the incision, but they are always single-chambered, without partitions.
Corpus luteum cyst. A cyst of a functional nature. The cyst of the corpus luteum has thickened walls and can be from two to seven centimeters in diameter. The inner surface of the cyst is often yellow, the contents are light, and with hemorrhages they are bloody.
Hemorrhagic.It is a consequence of hemorrhage inside the formed follicular cyst or corpus luteum cyst.
Endometrioid. It is formed when the tissues of the mucous membrane of the inner layer of the uterine wall grow in the ovaries. An endometrioid cyst is often filled with dark contents, blood, and its diameter ranges from two to several tens of centimeters.
Dermoid. It consists of parts of the embryonic germ sheets enclosed in a mucus-like mass, derivatives of connective tissue (fat, cartilage, skin). A dermoid cyst usually does not reach large sizes and grows slowly.
Mucinous. Benign epithelial tumor. The cavity of this cyst has an uneven surface and is filled with mucin, a slimy liquid that is the secret of the epithelium. A mucinous cyst can reach quite large sizes and have several chambers.
Serous. Benign epithelial tumor. The capsule surface is lined with serous epithelium. It contains a light straw-colored transparent liquid inside.
Epithelial tumors. They develop from the epithelial components of the ovary. They can be benign, borderline, or malignant.
Germinogenic tumors. They account for less than 5% of all neoplasms in the ovaries. At the same time, they are characterized by the most violent current. They are often quite large (more than fifteen centimeters).
Reasons
There are quite a few reasons for the development of an ovarian cyst.
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hormonal and endocrine disorders;
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early menstruation;
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artificial termination of pregnancy, including abortions;
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thyroid disorders;
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inflammatory diseases and sexual infections;
Complications
An ovarian cyst may have the following complications:
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Some types of cysts can become malignant if they persist for a long time. It should be remembered that only a histological examination can be an accurate method of diagnosing the nature of a cyst.
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Twisting of the cyst stem, which may be accompanied by severe pain, cyst rupture, which may result in the development of peritonitisInfertility.Specialists of the European Medical Center warn that it is very important to visit a gynecologist regularly (once a year) for timely diagnosis of pelvic pathology. In the case of an already identified ovarian cyst, the frequency of visits to the gynecologist is determined by the doctor individually.DiagnosticsThe cyst is diagnosed by the following methods:
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Gynecological examination. It allows you to determine the soreness in the lower abdomen and an increase in appendages.
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Ultrasound. The most informative method, as it allows not only to determine the presence of a cyst, but also to monitor its development.
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Ovarian laparoscopy. Not only is there an almost 100% method of cyst diagnosis, but also a method of its treatment.
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Pregnancy test. It is necessary to rule out ectopic pregnancy.
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Computed tomography or magnetic resonance imaging. These methods are used to determine the quality of the cyst, its location, size, structure, contours, and other parameters necessary for surgery.
TreatmentThe choice of cyst treatment depends on the nature of the cyst, its type, and the presence of complications. The most common functional cysts are usually treated with oral hormonal medications. Treatment of these cysts can take from two to three months, depending on the size of the formation. At the same time, the dynamics of treatment is monitored using ultrasound. If drug treatment is ineffective, surgical intervention is recommended.The surgical method is more often used as the main one for the treatment of complex organic cysts. Modern technologies assume laparoscopic intervention in such cases, which allows minimally damaging healthy tissues, minimizing complications from surgery and minimizing the duration of hospitalization to 1-2 days. In any case, during the operation, doctors will try to preserve the patient's ovary and reproductive capabilities as much as possible.
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Questions and answers
Lump in my breast
I have noted the lump in my breast periodically appeared following breastfeeding my first child (as a result of plugged duct). I did an ultrasound, but it revealed nothing, as if everything was normal. I knead my breast periodically and feel pain at those moments. Now I am pregnant, due date is on 20th. What should I
do?? When to examine my breasts, is it possible to perform the examination during pregnancy and lactation?
...more The "lump" in the breast cannot occur after feeding, even if it was the plugged duct. You should not "knead" the breasts. If there is a problem or even if you think it is – the breast should be examined. Pregnancy and breastfeeding are not contraindications for this. Under normal conditions for pregnant women we
recommend a breast examination during 1 and 3 trimester (before childbirth). There are no contraindications for breast examination in your case. You are welcome at any convenient time for examination and advice on breastfeeding.
...more
Benign disease
I have a benign lump in one breast size of 12.0*9.9 mm. Puncture or a biopsy will be done next week. I was told by mammologist that surgery is needed. As far as I know, concerning the surgery, axillary lymph nodes are to be removed together with the tumor. I also know that in Europe lymph nodes are testes for
specific markers and only affected ones should be removed; if lymph nodes are no affected, they are not to be dissected and the surgery is minimally invasive. So what is your approach? Does it make sense to do it or you have the same methods and the same equipment?
...more If histological examination of the sample reveals fibroadenoma of basic type or tissue hyperplasia without atypia, or nodular type fibrocystic condition of the breast tissue, the question of surgical treatment should not arise. If biopsy reveals giant fibroadenoma sectoral resection is indicated, i.e. mass excision
within the healthy tissues and lymph nodes will be removed. In case of non- benign histological result, i.e. carcinoma is detected, subsequent immunohistochemical examination is required as well as a clinical oncologist and surgeon consultation; and the decision on complex treatment will be taken by case management team. With regard to the diagnosis and treatment methods in our center, each case is addressed individually. Sometimes we remove a benign area (for example, the area of hyperplasia with atypia) using the vacuum-needle technique through 3-4 mm incision. As for the surgical procedure protocols for benign breast tumors, benign simple fibroadenoma is not removed in America, Europe, Israel, etc. I would like to discuss your case with you in more details and perform some additional tests if needed, so I would be glad to see you at EMC’s Breast center.
...more
Melanoma
My mom had a mole (suspected for melanoma) removed in November 2015. Histology revealed lentigo melanoma in situ. We checked the slides back in the Netherlands, and the diagnosis was a superficial spreading melanoma of Clark 3 Т1а Beslow 0,8 stage; re-excision with capture of 1 cm of healthy skin is recommended. Is
it possible to make re-excision and subsequent histology in your hospital? If so, how soon?
...more We absolutely agree with the opinion of the European colleagues: re-excision with a wider offset is required; according to the Russian Protocol it is necessary to move 2 cm from the peripheral edge. This is for counter insurance, as lentigo-melanoma is a favorable type, and previous surgery is likely to put an end to
this story and the forecast is favorable. All the necessary manipulations for the study are possible in our Clinic; we have our own well-equipped laboratory with the possibility to ask the advice concerning the sample in Germany and Israel.
You should make an appointment with the surgeon-oncologist (Marina Bissessar) in the nearest time to conduct the diagnostic re-excision. Hope to help!
...more
A spot on the back and chest
I have a spot on the back and chest, what could it be?
A spot on the skin is one of the most common symptoms of various skin diseases. Infectious (viral, bacterial or fungal) as well as noninfectious skin including serious diseases and nevi (moles or birthmarks) can manifest as spots on the skin. You should go to the dermatologist for accurate diagnosis. The doctor will
examine you and, if necessary, a special instrument (Dermatoscope, wood lamp) will be used. A skin scraping can also be done in the lesion for microscopy, cytology or culture. A treatment will be prescribed after diagnosis.
...more 
Batkaeva Nadezhda
07 September 2016
Uterine cancer
My mom was diagnosed with the uterine cancer. She is 68 years of age and has an obesity of 4th grade (the growth of 166 cm, weight 135 kg) and hypertension. Admission to the radiology department was recommended. What should we do? As far as I know the surgery is the only method for cancer of the uterus to be removed.
Is it really so that this surgery is only possible for young and relatively healthy persons?
...more It is not quite so. We can operate on any patient, but the issue is which complications can lead to patient’s death and which of them can just delay the recovery. From the anesthesiologist’s point of view, it is a major challenge to intubate patients with 4th degree obesity; the abdominal section is also possible,
but there is a 100% risk of suture line disruption and inflammation, let alone the postoperative pneumonia, venous thrombosis, etc. There is another option such as vaginal hysterectomy which is more acceptable and relatively safe in obese patients. It is not a «treatment standard», however, as it allows not obtaining pelvic washings, but still there is a possibility of complete cure. Anesthesia remains a problem - both general and spinal. Radiation therapy without surgery is another acceptable treatment option besides vaginal hysterectomy. A chance of complete cure is still exists, but the survival rate is on average lower than in surgical treatment
...more 
Vladimir Nosov
07 September 2016
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