Often, under the guise of a cyst, a patient may develop a borderline tumor, and on ultrasound and even MRI of the pelvis they may look indistinguishable from each other. Compared with a benign cyst, the cells of a borderline tumor have a high rate of division and, if left untreated, can transform into malignant ones. It is possible to distinguish a cyst from a borderline tumor only during a histological examination under a microscope, which is performed during or after surgery.
If, after the initial diagnosis, the cyst has not disappeared within 2-3 menstrual cycles, it means that it is not functional and requires removal. It is also important to remove almost all tumors in the ovaries of menopausal women.
The day before the operation, the patient performs intestinal cleansing procedures at home on his own. Ovarian cyst removal is performed on an empty stomach, the patient should not eat or drink 8 hours before surgery. It is also important to remove jewelry before surgery, avoid applying makeup and nail polish, and take a shower before surgery.
During surgery for an ovarian cyst, the surgeon completely removes one ovary or part of it with a neoplasm.
If there is a risk of rupture of the ovarian cyst during its removal, a complete resection of the ovary along with the tumor is recommended. If, according to the results of histology, this is a borderline tumor, a biopsy of the peritoneum and removal of the large omentum are performed during the operation. This is important in order to prevent the spread of the tumor beyond the ovary.
Before surgery, doctors can only suspect a borderline tumor based on its size and structure, as well as an increase in certain cancer markers. Most often, such tumors occur in women after the age of 30, so the age group of the patient is also taken into account. An accurate diagnosis is made only after surgical treatment. It is oncologically unsafe to perform a biopsy of cysts without surgery: if the neoplasm turns out to be non-benign, as a result of such a puncture, the contents of the cyst will spill into the pelvic cavity. If the cyst is suspicious to the doctor, the operation is performed with an urgent histology during the operation.
Treatment of cysts and borderline tumors differs in the postoperative period. If, according to the results of histology, the tumor turned out to be benign, surgical treatment is sufficient.
With borderline cysts, there is a high probability of recurrence on the other ovary. A borderline cyst occurs in every second woman after the first operation. If the patient has a healthy second ovary, her reproductive potential does not deteriorate.
Therefore, if she wants to have a baby, doctors recommend planning a pregnancy one and a half to two months after the first operation (including staging) in order to have time before a relapse occurs.
