Ovarian cyst
| Classification according to ICD-10 | |
|---|---|
| D27 | Benign neoplasm of the ovary |
| D39.1 | New formation of unsafe or unknown behavior: ovary |
| N83.0 | Follicular cyst of the ovary |
| N83.1 | Corpus luteum cyst |
| N83.2 | Other and unspecified ovarian cysts |
| E28.2 | Polycystic Ovarian Syndrome |
| N80.1 | Endometriosis of the ovary |
| ICD-10 online (WHO version 2019) | |
The ovarian cyst ( ovarian cyst ) is a sac-like cavity or tumor that is formed in or on the ovaries in humans or mammals and is filled with fluid of different consistencies, or a tumor that is usually benign. It grows from a few millimeters to over 15 centimeters in diameter.
to form
Most ovarian cysts are functional cysts . Functional cysts can develop as a result of normal, hormonal , cyclical changes in the ovary. But they also occur because of a disturbed hormone balance or as a side effect of hormone therapy . Functional cysts are found almost exclusively in sexually mature women , often shortly after puberty and during menopause .
The most common functional cysts are:
- Follicle cysts (vesicle cysts) can persist for a long time and also be hormonally active. Most of the time they recede spontaneously or burst. They grow up to 10 cm in size and arise from persistent Graaf follicles .
- Corpus luteum cysts: The so-called corpus luteum (Latin corpus luteum) arises after ovulation from the remains of the cracked Graaf's follicle. A corpus luteum cyst is a cystically enlarged corpus luteum caused by hemorrhage and usually regresses spontaneously.
- Lutein cysts usually appear multiple times in both ovaries. After treatment of the underlying disease or discontinuation of hormone treatment, lutein cysts usually regress spontaneously.
- Polycystic ovaries as a special form of functional cysts are a main feature of polycystic ovary syndrome (PCO), a separate clinical picture.
Another independent clinical picture that can lead to the formation of cysts on the ovary is so-called endometriosis . Endometriosis cysts have a characteristic appearance. They contain blood breakdown products thickened in chocolate and are therefore also known as chocolate cysts.
The rarer retention cysts arise from secretion retention of glands.
Dermoid cysts are primarily benign changes and can reach a diameter of up to 25 cm. Most often they occur in girls before puberty and young women. Degeneration into a malignant tumor occurs in one to two percent of cases, mainly in women over 40 years of age.
Diagnosis
Often ovarian cysts are only a few centimeters in size and cause no symptoms . They are discovered in the ultrasound examination at the gynecologist. Modern ultrasound devices can detect cystic changes on the ovary that are just a few millimeters in size and are harmless. According to current estimates, abnormal findings on the ovary in the vaginal ultrasound image are normal changes in over 98 percent of cases that do not require an operation.
therapy
Therapy depends on the underlying cyst type. The most common ovarian cysts in sexually mature women do not primarily require any therapy, as they often regress spontaneously and only cause symptoms when they are above a certain size. One reason for treatment for functional cysts is persistent, i.e. H. cysts that do not regress spontaneously, severe complaints, complications and new ovarian cysts after menopause.
Therapeutic step-by-step plan for sexually mature women:
- If the ultrasound shows the typical picture of a functional cyst, you should first wait and then carry out an ultrasound check-up after your period.
- If the cyst persists, hormonal therapy is attempted over a period of three months, with gestagens in the second half of the cycle.
- After an unsuccessful hormonal therapy attempt, in the event of complaints or complications, the cyst is removed with the help of a laparoscopy .
In the case of new ovarian cysts in the postmenopause, an operation is advisable, as this can also be a malignant tumor.
Serious complications are rare with ovarian cysts. A sudden bursting (Latin rupture ) of ovarian cysts is observed in three percent of patients. This usually occurs spontaneously, but it can also be triggered by a vaginal examination by the gynecologist. This process is usually harmless, but for those affected it can be associated with severe abdominal pain and even collapse. Rarely, rupturing blood vessels can cause bleeding in the abdomen, which must be treated surgically.
Larger cysts, especially endometriosis cysts, can be movably connected to the ovary via a vascular pedicle. A so-called stem rotation as a result of sudden jerky movement leads to a throttling of the blood supply. This represents a life-threatening situation that must also be corrected surgically.
Dermoid cysts are surgically removed. Likewise, large endometriosis cysts that cause discomfort. In the case of extensive endometriosis or severe symptoms, additional supplementary hormone treatment can be useful. The therapy planning depends on the age of the patient, the symptoms, the extent of the disease or a possible desire for children.
Polycystic ovaries as part of PCO are treated with hormones. A partial surgical removal may be performed.
