What are the symptoms of pelvic cysts?

Pelvic cysts are relatively common ovarian cysts. Because the ovaries are located relatively deep in the pelvic cavity, they are not easily discovered after the disease occurs. After diagnosis, they are usually in the late stage. Pelvic cysts can be divided into many types according to their nature. We need to be aware of the symptoms of pelvic cysts and take timely measures to treat them when abnormalities are discovered. So, what are the symptoms of pelvic cysts? Let’s take a look below.

Clinical manifestations

1. Benign ovarian tumor

In the early stages, the tumor is small and often asymptomatic, and is often discovered accidentally during a gynecological examination. When the tumor grows to medium size, there will be a feeling of abdominal distension or a mass with clear boundaries can be felt in the abdomen. Gynecological examination revealed spherical masses on one or both sides of the uterus, which were mostly cystic, with smooth surface, movable and no adhesion to the uterus. If the tumor grows large enough to fill the pelvis and abdominal cavity, compression symptoms will appear, such as frequent urination, constipation, shortness of breath, palpitations, etc. The abdomen is distended, the mass is poorly mobile, percussion is solid, and there is no mobile dullness.

2. Ovarian malignancy

There are no symptoms in the early stages and it can be detected during a gynecological examination. The main symptoms are abdominal distension, abdominal mass and ascites. The severity of the symptoms depends on the size and location of the tumor, the degree of invasion of adjacent organs, the histological type of the tumor, and the presence or absence of complications. In the late stage, cachexia symptoms such as weight loss and severe anemia may occur.

diagnosis

1. Imaging examination

(1) B-ultrasound examination of the location, size, and shape of the tumor can indicate whether the tumor is cystic or solid, whether there are papillae in the cyst, and identify the type of ovarian tumor, whether there is ascites, and whether it is encapsulated effusion.

(2) If the abdominal plain film is an ovarian teratoma, teeth and bones can be seen. The cyst wall is a calcified layer with increased density, and the cyst cavity appears as a radiolucent shadow.

(3) CT examination shows that benign tumors are mostly uniformly absorbed, with thin and smooth cyst walls; malignant tumors have irregular contours, infiltrate the surrounding areas or are accompanied by ascites, and can also show whether there is metastasis to other organs or lymph nodes.

2. Tumor markers

Currently, there is no tumor marker that is exclusive to a certain tumor. Various types of ovarian tumors may have relatively specific markers for auxiliary diagnosis and disease detection.

(1) CA125 is sensitive to epithelial tumors;

(2) AFP has specific value for ovarian endodermal sinus tumor;

(3) HCG is specific for primary ovarian choriocarcinoma;

(4) Sex hormones: Sex cord-stromal tumors produce higher levels of estrogen.

3. Laparoscopy

The condition of the mass can be directly observed, the pelvic cavity, abdominal cavity and diaphragm can be inspected, multiple biopsies can be performed on suspicious areas, and peritoneal fluid can be aspirated for cytological examination.

4. Cytological examination

Finding cancer cells in ascites or peritoneal washings is helpful for further staging and treatment selection for stage I patients.

Differential Diagnosis

1. Ovarian malignancy

The disease usually has a short course and progresses rapidly. It is mostly bilateral, solid or cystic, irregular, and often accompanied by ascites. There may be weight loss and cachexia. B-ultrasound shows chaotic light clusters and spots in the liquid dark area with unclear boundaries. The blood flow is often abnormally rich. At the same time, tumor indicators such as CA125 may be elevated.

2. Benign tumors of ovarian origin

The most common are teratomas, serous cystadenomas, mucinous cystadenomas or simple cysts, which can be seen in any age. Physical examination may reveal an adnexal mass, and tumor markers are usually normal. Ultrasound examination may show that the mass is cystic or solid.

3. Pelvic inflammatory mass

She had a history of pelvic inflammatory disease, accompanied by abdominal pain, fever, increased leucorrhea and elevated blood count. Gynecological examination revealed palpable masses in the bilateral adnexal areas, which were fixed, immobile, and had unclear boundaries with the surrounding tissues. There is tenderness. The mass can be significantly reduced after anti-infection treatment.