Ovarian cysts are closed, sac-like structures within the ovary that are
filled with a liquid or semisolid substance
Ovarian cysts are very common. They can
occur during the childbearing years or after
menopause. Most ovarian cysts are benig
n (not cancer) and go away on their own
without treatment. Rarely, a cyst may be
What are the different types of ovarian cysts?
Follicle cysts. In a normal menstrual cycle, the egg grows inside a tiny sac called a follicle. When the
egg matures, the follicle breaks open to release the egg. Follicle cysts form when the follicle doesn’t br
eak open to release the egg. This causes the follicle to continue growing into a cyst. These cysts often
have no symptoms and go away in one to three months.
Corpus luteum cysts. Once the follicle breaks open and releases the egg, the empty follicle sac shri
nks into a mass of cells called corpus luteum. Corpus luteum makes hormones to prepare for the next
egg for the next menstrual cycle. Corpus luteum cysts form if the sac doesn’t shrink. Instead, the sac r
eseals itself after the egg is released. Then fluid builds up inside. Most corpus luteum cysts go away a
fter a few weeks, but they can grow to almost four inches wide. They also may bleed or twist the ovary
and cause pain. And they are most commonly ruptured.
Pathological ovarian cyst
dermoid cysts: sac-like growths on the ovaries that can
contain hair, fat, and other tissue
cystadenomas: noncancerous growths that can
develop on the outer surface of the ovaries
endometriomas: tissues that normally grow inside the
uterus can develop outside the uterus and attach to the
ovaries, resulting in a cyst
Symptoms of an ovarian cyst
Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as
the cyst grows. Symptoms may include:
abdominal bloating or swelling
painful bowel movements
pelvic pain before or during the
pain in the lower back or thighs
nausea and vomiting
Severe symptoms of an ovarian cyst that
require immediate medical attention incl
severe or sharp pelvic pain
faintness or dizziness
Diagnosing an ovarian cyst
the following tests may be recommended to find out more information:
Which of the following types of cysts most commonl
2. Corpus luteum cysts
3. Dermoid cysts
Corpus luteum cysts tend to be larger and more symptoma
tic than follicular cysts and are more prone to hemorrhage
and rupture. Follicular cysts are usually smaller, with intern
al hemorrhage being relatively uncommon.
Which of the following is not associated with sympto
ms of ovarian cyst rupture?
1. Abdominal distention
2. Unilateral pelvic pain
4. Peritoneal signs
Cyst rupture is characterized by sudden, unilateral, sharp pelvic pain. This can be associated with trau
ma, exercise, or coitus. In addition, cyst rupture can lead to peritoneal signs, abdominal distention, an
d bleeding that is usually self-limited.
Which of the following is the preferred imaging modality for
assessing ovarian cysts with or without rupture?
Ultrasonography is the preferred imaging modality for assessing gynecologic structures, given its low
cost, availability, and sensitivity in recognizing adnexal cysts and hemoperitoneum. Despite this, ultras
ound findings are nonspecific in some instances, particularly after rupture and decompression of a cys
t in the setting of apparent physiologic levels of fluid in the pelvis. If ultrasound yields ambiguous resul
ts in a patient with significant pain, CT of the pelvis with contrast should be performed.
Cancer is always a concern with ovarian cysts, and cancer antigen 1
25 (CA-125) testing is often used to investigate for ovarian cancer. W
hich of the following is a contraindication to CA-125 testing?
1. Age 20-30 years
Keep in mind the possibility of cancer when managing an ovarian cyst.  Cancer antigen 125 (CA1
25) is a protein expressed on the cell membrane of normal ovarian tissue and ovarian carcinomas. A s
erum level of less than 35U/mL is considered normal, although in some laboratories, the upper limit of
normal may be lower than this.
CA-125 testing should not be done in pregnant patients with ovarian cysts because levels are significa
ntly higher, especially during the first trimester. CA-125 testing should also not be done in the acute se
tting of ovarian cyst accidents, as this marker is raised in peritonitis, hemorrhage, cyst rupture, and inf
ection, as well as in menstruation, fibroids, and endometriosis.
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in this presentation we wrote about phases of ovarian cysts and how it form in the ovary and its symptoms management .