Ovarian Cysts and Tumors: A Comprehensive Guide to Diagnosis and Management

Ovarian tumors refer to abnormal growths in the ovaries, which can be benign or malignant. Ovarian cysts are fluid-filled sacs in the ovary, which may be functional or pathological.

Types of Ovarian Tumors

1. Benign Ovarian Tumors

Functional Cysts

    • Follicular Cyst
    • Corpus Luteum Cyst
    • Theca Lutein Cyst

Epithelial Tumors

    • Serous Cystadenoma
    • Mucinous Cystadenoma
    • Brenner Tumor

Germ Cell Tumors

    • Mature Teratoma (Dermoid Cyst)

Sex Cord Stromal Tumors

    • Fibroma
    • Thecoma
    • Granulosa Cell Tumor

 2. Malignant Ovarian Tumors

Epithelial Ovarian Cancer (Most Common, 90%)

    • Serous Cystadenocarcinoma
    • Mucinous Cystadenocarcinoma
    • Endometrioid Carcinoma

Germ Cell Tumors

    • Dysgerminoma
    • Yolk Sac Tumor
    • Immature Teratoma

Sex Cord Stromal Tumors

    • Granulosa Cell Tumor
    • Sertoli-Leydig Cell Tumor

 Ovarian Cysts

1. Functional Cysts

  • Follicular Cyst: Forms when the follicle fails to rupture.
  • Corpus Luteum Cyst: Occurs when the corpus luteum fills with fluid.
  • Theca Lutein Cyst: Associated with high hCG levels (e.g., in molar pregnancy).

2. Pathological Cysts

  • Endometriotic Cyst (Chocolate Cyst): Associated with endometriosis, filled with old blood.
  • Dermoid Cyst (Mature Teratoma): Contains hair, teeth, and sebaceous material.

Clinical Features of Ovarian Tumors

  • Asymptomatic (In Early Stages)
  • Pelvic Pain or Pressure Symptoms
  • Abdominal Mass or Distension
  • Menstrual Irregularities
  • Infertility
  • Ascites (In Malignant Tumors)

Diagnosis of Ovarian Tumors

1. Clinical Examination

o   Palpation of an adnexal mass on bimanual examination.

2. Imaging Studies

o   Transvaginal Ultrasound (TVUS) – First-line imaging.

o   MRI / CT Scan – For further characterization.

3. Tumor Markers

o   CA-125 – Elevated in epithelial ovarian cancer.

o   AFP, β-hCG, LDH – For germ cell tumors.

o   Inhibin & Estrogen – For granulosa cell tumors.

4. Histopathology

o   Definitive diagnosis obtained by biopsy or surgical excision.

Management & Treatment

1. Conservative Management (For Functional Cysts)

  • Observation & Follow-Up (Most regress spontaneously).
  • OCPs (Oral Contraceptive Pills) – To prevent recurrence.

2. Surgical Management

  • Cystectomy – Removal of benign cysts.
  • Oophorectomy – Removal of the affected ovary.
  • Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy (TAH-BSO) – For malignant tumors.
  • Debulking Surgery – For advanced ovarian cancer.

Complications of Ovarian Tumors

  • Rupture of Cyst → Causes acute abdomen & peritonitis.
  • Torsion of Ovary → Leads to sudden severe pelvic pain.
  • Malignant Transformation (Rare in benign tumors).

Keynote Symptoms of Ovarian Tumors & Cysts

  • Pain in the ovarian region, often radiating to the thighs or back
  • Irregular or suppressed menstruation due to hormonal imbalance
  • Heaviness, bloating, and distension in the lower abdomen
  • Infertility due to anovulation or obstruction in the ovaries
  • Cystic formations or hard lumps detected in the ovaries on ultrasound

1. Apis Mellifica

Indications:

  • Ovarian cysts, especially right-sided, with burning, stinging pain
  • Pain and tenderness in the ovarian region, worse from touch and heat

Keynote Symptoms:

  • Swelling and tenderness over the ovaries.
  • Worse from warmth and better from cold applications.
  • Stinging, burning pain in the ovaries.
  • Suppressed menses with ovarian swelling.
  • Increased thirst for small sips of water.

2. Lachesis

Indications:

  • Left-sided ovarian tumors or cysts with congestion and pain
  • Symptoms worsen before menses and improve after the flow begins

Keynote Symptoms:

  • Left-sided ovarian pain, worse from tight clothing.
  • Menstrual flow is profuse, dark, and clotted.
  • Symptoms worsen after sleep.
  • Pain worsens with heat and touch.
  • Emotional sensitivity and excessive talkativeness.

3. Thuja Occidentalis

Indications:

  • Ovarian cysts associated with PCOD (Polycystic Ovarian Disease)
  • Irregular periods, excessive hair growth, and obesity

Keynote Symptoms:

  • Ovarian pain with a sensation of something alive moving inside.
  • Warts or growths on the skin accompany ovarian cysts.
  • Worse from damp weather and cold exposure.
  • Menstrual cycle irregular, with delayed and scanty flow.
  • Tendency to develop benign tumors, cysts, and polyps.

4. Calcarea Carbonica

Indications:

  • Ovarian cysts with sluggish metabolism, weight gain, and cold sensitivity
  • Menstrual disturbances with profuse bleeding and clot formation

Keynote Symptoms:

  • Cold, clammy feet with excessive sweating.
  • Weakness, exhaustion, and fear of impending trouble.
  • Craving for eggs and indigestible substances.
  • Ovarian pain worse from exertion and damp weather.
  • Menstrual flow is heavy, prolonged, and associated with clot formation.

5. Pulsatilla

Indications:

  • Ovarian cysts in mild, gentle, and weepy women
  • Delayed, scanty, or absent periods with mood swings

Keynote Symptoms:

  • Pain in ovaries shifts from side to side.
  • Delayed or suppressed menstruation with mild cramping.
  • Worse in warm rooms and better in open air.
  • No thirst despite dryness of mouth.
  • Emotional sensitivity, tearfulness, and desire for consolation. 

Post a Comment

Previous Post Next Post