What is an ovarian cyst?

Ovarian cysts can be said to be a common disease among women. Many women may suffer from this disease. However, due to the lack of medical knowledge, women have no understanding of this disease at all. What is ovarian cyst? Only by understanding this disease well can people have a more correct understanding and know how to deal with it. Let's analyze it for people below.

ovarian cyst

Department

Obstetrics and Gynecology

High incidence group

Women aged 20 to 50

Common causes

Related to genetic, endocrine, environmental and other factors

Common symptoms

A mobile, nontender, medium-sized or smaller intra-abdominal mass

1. Genetic factors

According to statistics, 20% to 25% of ovarian tumor patients have a family history.

2. Endocrine factors

The ovaries are important organs for ovulation and secretion of gonadal hormones. Ovarian tumors often occur during the reproductive age. Clinically, the basic pathophysiological change in many patients with ovarian cysts and polycystic ovary syndrome is that the ovaries produce too much androgen, and the excessive production of androgen is the result of the synergistic effect of abnormal functions of multiple endocrine systems in the body.

3. Lifestyle factors

Long-term bad diet structure, living habits, and excessive psychological stress can lead to physiological ovarian cysts and true ovarian tumors.

4. Environmental factors

Food contamination, such as plant growth hormones used in vegetables, and hormone ingredients such as clenbuterol in formula feeding of livestock and poultry. In recent years, with the improvement of living standards and changes in eating habits in my country, as well as the abuse of hormone drugs and tonics such as breast augmentation, weight loss, and anti-aging by some young and middle-aged women, the high incidence and younger age of ovarian tumors may also be related.

Clinical manifestations

The most significant feature of an abdominal mass that is smaller than medium in size, if without complications or malignant transformation, is its mobility, which can often move from the pelvic cavity to the abdominal cavity. In malignant or inflammatory conditions, the tumor is restricted in movement, tenderness is present, and even symptoms of peritoneal irritation and ascites may occur.

examine

Pregnancy test, gastroscopy, fiber colonoscopy, color Doppler ultrasound, MRI, serum tumor markers, etc., and in some special cases, abdominal puncture, laparoscopy, laparotomy, etc.

1. Laparoscopy

The general condition of the tumor can be directly seen, the entire pelvic and abdominal cavity can be observed, multiple biopsies can be taken at suspicious sites, and peritoneal fluid can be absorbed for cytological examination to confirm the diagnosis and provide postoperative monitoring. However, it is contraindicated for patients with huge or adhesive masses, and the retroperitoneal lymph nodes cannot be observed.

2. Radiological diagnosis

MRI, CT, etc. are helpful in diagnosing tumor metastasis to the liver, lungs, and retroperitoneal lymph nodes. A plain abdominal radiograph can aid in the diagnosis of intestinal obstruction.

3. Secondly

If the cyst is a malignant ovarian tumor, like other tumors, it can produce and release a variety of products such as antigens, hormones and enzymes. These substances can be detected in the patient's serum through immunological, biochemical and other methods. They are called tumor markers and indicate the presence of a certain tumor in the body.

(1) The antigen marker CA125 is a relatively sensitive tumor marker for ovarian tumors. AFP is the best tumor marker for endodermal sinus tumor. The AFP value may also be elevated in immature teratomas. The increase in AFP often precedes clinical signs, and it is of great significance in diagnosis and monitoring.

(2) The hormone marker human chorionic gonadotropin β subunit (β-hCG) is a highly specific marker for gestational trophoblastic disease, and its serum concentration is often elevated in patients with ovarian choriocarcinoma. Estrogen levels are elevated in patients with granulosa cell tumors and theca cell tumors. 30% of patients with testicular blastoma have increased urinary 17-ketosteroid excretion.

(3) The excretion of enzyme marker/lactate dehydrogenase (LDH) is increased in patients with ovarian malignant tumors.

The diagnosis of ovarian cysts often varies in difficulty depending on the size and characteristics of the tumor. When taking a detailed medical history, attention should be paid not only to the reproductive organs, but also to the general condition and the relevant medical history of other important organs. Combining clinical manifestations with physical examinations, in addition to paying attention to the characteristics of the tumor itself, the general condition should also be understood. Therefore, not only gynecological examinations, but also general examinations, especially abdominal examinations, are extremely important. If necessary, other auxiliary diagnostic methods should be used, and a correct diagnosis can only be obtained after a comprehensive analysis of the medical history.

Patients with ovarian cysts may have a history of abdominal masses. Through abdominal palpation and bimanual examination, the boundaries and mobility of the uterus and the mass can usually be determined.

treat

Surgical treatment: The treatment of ovarian cysts depends on factors such as the patient's age, whether it is malignant, the location, volume, size, growth rate of the cyst, whether the reproductive function is preserved, and the patient's subjective wishes.

1. Surgical treatment of benign ovarian cysts

(1) Ovarian cystectomy: This procedure is often used in young patients, especially premenopausal patients, while preserving normal ovarian tissue as much as possible.

(2) Salpingo-oophorectomy: Older patients (over 45 years old) or postmenopausal patients can undergo unilateral or bilateral salpingo-oophorectomy.

2. Surgical treatment of malignant ovarian cysts

(1) Most patients are in the advanced stage when they seek medical treatment, so every effort should be made to remove the primary cyst and any visible pelvic and abdominal metastases.

(2) Consider placing a catheter in the peritoneal cavity to facilitate the postoperative intraperitoneal injection of chemotherapy drugs.