Cystic lesions in the ovary are usually benign. They can vary in size, present unilaterally or bilaterally. May present with pain, irregular menses, abdominal bloating or asymptomatic diagnosed on a routine ultrasound examination. An ultrasound Doppler coupled with blood tests which is the CA 125 can help rule out any malignant changes. Occasionally in endometriotic or chocolate cysts the Ca 125 may be borderline raised.
Small cysts can be observed following the next period and mostly are found to disappear. Larger cysts can be observed after a course of hormones to check if the cyst has resolved. If resolved then she is advised a follow up on a 6 monthly basis. If the cyst is persists then she is offered a choice of a laparoscopic ovarian cystectomy. Laparoscopy offers a fertility enhancing approach , is less painful and the patient can seek discharge within 36 hrs of the surgery.
Occasionally there can be an occurrence of teratomas. These are cysts in the ovary either unilateral or bilateral. These cysts originate from all layers as in the mesoderm, endoderm and ectoderm ,and hence can contain hair , teeth and bone with fat in it. It is important to understand that occasionally cysts can undergo torsion and present with excruciating pain. Even if the cyst appears discoloured or black with ultrasound Doppler suggesting complete torsion there is no place to remove that ovary as it would result in partial castration of the girl. Modern surgical principles advise against an ooprectomy. All ovarian lesions have to be evaluated with an MRI. Contact Dr Ranjana Dhanu to get the best treatment for ovarian cancer screening in mumbai.
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