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The real threat to life is malignant ovarian tumors. About malignant ovarian cyst

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Questions and answers on: can a cyst develop into cancer?

2012-12-19 04:33:14

Rima asks:

Hello! I AM DELAYED BY ABOUT 6 WEEKS, my last period was on November 2, I went to the doctor and the answer was that I was pregnant, they sent me for an ultrasound to accurately determine the due date, but the ultrasound did not confirm the pregnancy and the diagnosis was... a cyst of the right ovary. The body of the uterus is in the midline, size 51-45-55 mm, the contours are clear, even, the structure is homogeneous, the echogenicity is average. M-ECHO 16 mm, clear, even contours. The structure of the indometrium is heterogeneous, increased ec-ti with hypoechoic inclusions. The uterine cavity is not dilated, not deformed. The cervix size is 27 by 23 mm, homogeneous, the structure of the endocervis is homogeneous, the cervical canal is not dilated, not deformed. The right ovary is usually located, size 37 by 25, even and clear. The follicular apparatus is degenerate. The bulky formation contains a 25mm corpus luteum cyst. Left ovary 30-19 follicles up to 6. There are no structural changes in the parametrium and in the regular space. DIAGNOSIS: hyperglacial indometrium, non-conical ovum, cyst of the right ovary. You see, I didn’t have delays before, this was the first time I was 37 liters, could it be menopause during menopause. My breasts have become swollen and I have had no abdominal pain for the last 5 days. I feel normal. And will my menstruation come, should I worry that the cyst will develop into cancer?

2012-06-07 07:27:40

Natalya asks:

Hello, I’m 34 years old, I haven’t given birth, I haven’t had an abortion. In the middle of my cycle, I started having bloody discharge. I did an ultrasound - the uterus is 53x49x68 mm, myomatous, M-Echo 9 mm (day 16 of the menstrual cycle). Along the anterior wall of the uterus on the left sub. inter. node., contacts the uterine cavity and interomodular duct 39x25x27 mm. In the uterus there are endocervical cysts up to 5 mm. ETC. ovary -39x18 mm, follicles up to 7 mm. Left, ovary 38x22 mm, follicles up to 7 mm. and psidosn. formation of irregular shape 11x10 mm. Conclusion: Uterine fibroids 5 weeks. Multifollicular changes in the ovaries, the state after ovulation on the left, signs of fragmented endometrial growth. The doctor said that it is very dangerous, it will develop into cancer, I don’t know how to treat it. All that can be done is only for those who have children. And the question of discharge in the middle of the cycle associated with ovulation is how much it can be. And the fact that the node is located on the anterior wall of the uterus and is in contact with the uterine cavity and the intermodular duct. Could it be that he will pierce the uterus and there will be uterine bleeding. What is the probability. I'm wondering how likely this is. I will now begin a full examination. I don’t know how long it will take, but if you confirm my suspicion, then I need to do something now, because if bleeding starts, suddenly it won’t be stopped. Very worried. Please explain me. I look forward to your reply with great impatience. Thank you very much in advance.Thank you very much in advance.

2008-08-31 21:17:45

Anna asks:

I have been married for 10 years - 9 of them I have not been able to conceive a child. All examinations by the gynecologist ended with a diagnosis of health. My husband's spermogram is excellent. I had a laparoscopy half a year ago. PGI: follicular cyst - 5 cm and serous cystoadenoma (internal-external endometriosis). I took triptorelin 3.75 times. There were terrible hot flashes every 20 minutes, high blood pressure, etc. After the 3rd injection, a day later I was taken to the hospital by ambulance - adhesions, bilateral adnexitis, toxicity of the body, blood leukocytes - 29 thousand. She underwent a course of treatment with intravenous antibiotics, resorption therapy, etc. My periods have not returned - they are induced by dydrogesterone for two months. One follicle appeared in one ovary. Diagnoses: internal-external endometriosis, uterine adenomyosis, salpinginitis, chronic cervicitis, ovarian cystoma, follicular cyst, NOMC, dysplasia. What should I do with all this? Not a single clinic or private clinic wants to take on me. Could this all develop into cancer? (I have a number of other diseases - mitral valve prolapse, hypertensive type blood pressure, moderate myopia, sand and salts in both kidneys and gall bladder, liver hemangioma - 1 cm, asthenia, chronic cholecystitis, gastritis, chronic pharyngitis). And do I have any hope of having children? Really looking forward to the answer.

Answers Bystrov Leonid Alexandrovich:

Hello Anna! Your case is not a simple one - there is a very large “bouquet of diseases”. I think you should come (I don’t know where you live) for a serious examination and treatment at the Kiev Scientific Research Institute of Obstetrics and Gynecology, where the result of the examination will determine: 1. Whether pregnancy is contraindicated for you. 2. Will you be able to carry her safely? 3. Is the IVF program and/or surrogacy possible (all this taking into account the complex of your illnesses) or is it worth taking the child in for upbringing (adoption, adoption).

2008-07-26 12:53:10

Anna asks:

I have been married for 10 years - 9 of them I have not been able to conceive a child. All examinations by the gynecologist ended with a diagnosis of health. My husband's spermogram is excellent. I had a laparoscopy half a year ago. PGI: follicular cyst - 5 cm and serous cystoadenoma (internal-external endometriosis). I took triptorelin 3.75 times. There were terrible hot flashes every 20 minutes, high blood pressure, etc. After the 3rd injection, a day later I was taken to the hospital by ambulance - adhesions, bilateral adnexitis, toxicity of the body, blood leukocytes - 29 thousand. She underwent a course of treatment with intravenous antibiotics, resorption therapy, etc. My periods have not returned - they are induced by dydrogesterone for two months. One follicle appeared in one ovary. Diagnoses: internal-external endometriosis, uterine adenomyosis, salpinginitis, chronic cervicitis, ovarian cystoma, follicular cyst, NOMC, dysplasia. What should I do with all this? Not a single clinic or private clinic wants to take on me. Could this all develop into cancer? (I have a number of other diseases - mitral valve prolapse, hypertensive type blood pressure, moderate myopia, sand and salts in both kidneys and gall bladder, prolapse of both kidneys, liver hemangioma - 1 cm, asthenia, chronic cholecystitis, gastritis, chronic pharyngitis). And do I have any hope of having children? Really looking forward to the answer.

An ovarian cyst is a benign tumor-like formation filled with fluid. Pathology is detected at any age, including in adolescents and menopausal women. It is asymptomatic and can cause menstrual irregularities and lower abdominal pain. Some ovarian formations are prone to spontaneous regression, others to uncontrolled growth. You can find out the type of pathology and decide on treatment tactics after a full examination by a gynecologist.

Can an ovarian cyst develop into cancer? According to statistics, this happens extremely rarely - barely 0.01% of cases. However, under the guise of a seemingly harmless formation, a true tumor, including a malignant one, can be hidden. In the initial stages of development, cancer imitates a cyst, and identifying a dangerous disease is quite difficult. An accurate diagnosis is sometimes made only after removal of the tumor and histological examination.

Is a cyst almost cancer?

An ovarian cyst is always a benign formation. Finding a cavity filled with fluid in the ovaries is not a reason to panic. In young women, such a pathology is extremely rarely the first stage of a malignant process. With a high degree of probability, the examination will reveal a pathology that does not pose a threat to life.

Schematic representation of ovarian cyst and cancer.

In gynecology, all ovarian formations are usually divided into three groups:

Benign – these include both cysts and true tumors. They are detected more often during reproductive age. Do not metastasize;
Borderline – formations occupying an intermediate position. Such tumors are similar in clinical picture to benign ones, but their cellular structure resembles malignant ones. They practically do not metastasize, but are prone to relapse. Identified mainly after 30 years;
Malignant - characterized by invasive growth (grow into surrounding tissues), give metastases. They are usually discovered during menopause.

Is it possible to confuse a cyst and ovarian cancer? Yes, this is possible. In the early stages, these diseases are practically the same, and it will not be possible to make an accurate diagnosis without examination. There are many methods to suspect a dangerous tumor, but the final verdict is given only by the histological conclusion.

These pictures show the histological structure of ovarian cysts and cancer.

Which cysts degenerate into cancer?

Not every ovarian formation is an oncological process. The likelihood of malignant degeneration depends on its type:

A follicular cyst does not contain adenogenic epithelium, so it cannot turn into cancer. Such formations spontaneously regress within three months in 80% of cases;
A luteal cyst is formed from the corpus luteum. The likelihood of malignancy has not been proven. Prone to spontaneous disappearance, therefore not considered a risk factor for cancer;
An endometrioid cyst occurs during the reproductive period and may regress during menopause. No reliable data on its malignancy have been obtained. It is believed that large lesions (from 9 cm) are prone to malignancy. It has been observed that the existence of endometriosis increases the likelihood of developing ovarian and intestinal cancer;
When examined, a simple serous cyst often turns out to be a true tumor. Possible degeneration into cancer;
Paraovarian cysts are asymptomatic and are therefore detected when they reach a large size. The possibility of malignancy cannot be excluded;
Dermoid cyst is a congenital pathology. Contains elements of embryonic tissues (nails, hair, fat and nerve cells). May develop into a malignant neoplasm;
A hemorrhagic cyst is not a separate pathology. A cavity filled with blood arises from any ovarian formation. Cannot be considered a sign of malignancy.

Different types of ovarian cysts.

On a note

It is believed that cancer is more often detected on the right ovary, while malignancy occurs less frequently on the left. No scientific evidence has been found for this theory. On the right, tumors are indeed more likely to form - both benign and malignant, which is explained by the active blood supply to this zone. Ovulation occurs more often in the right ovary, but this factor cannot indicate the risk of malignancy. Reliable statistics on this issue have not yet been provided.

Risk factors: who is at risk for ovarian cancer

It is not known for certain how often an ovarian cyst degenerates into cancer. Experts indicate that no more than 0.01% of cases, but this figure may vary depending on the presence of risk factors:

Age. In young women, it is extremely rare for a cyst to develop into a malignant tumor. The likelihood of malignancy increases after 40 years;
Critical periods of development. The appearance of a cavity in the ovaries in girls who have not entered puberty, as well as in postmenopause, deserves special attention;
Anamnesis. If the cyst recurs, a thorough examination is required - the development of a borderline tumor that can degenerate into cancer is possible;
Concomitant pathology. Often, malignant neoplasms of the appendages are detected against the background of cancer of the uterus, mammary glands, and intestines;
Heredity. There are known cases of familial ovarian cancer - both organ-specific (only in the appendages) and associated with other tumors (endometrium, breast).

If a cyst is detected in a woman at risk, a targeted examination is indicated to exclude ovarian cancer.

Genetic inheritance of ovarian cancer.

Is it possible to distinguish a cyst from a malignant formation? Leading symptoms

At the initial stages of development, the symptoms of cancer and cysts are similar, so it is almost impossible to distinguish one disease from another.

General signs of ovarian tumors:

Drawing pain in the lower abdomen. Occurs when the formation grows to 5 cm in diameter. The pain radiates to the lumbar region, goes to the buttocks and thigh;
Impaired function of the bladder and rectum occurs when these organs are compressed. As the formation grows, frequent urination and constipation are observed.

In almost 80% of women, a malignant tumor is diagnosed in late stages. Cancer is asymptomatic and is often detected when atypical cells spread throughout the body.

The spread of a malignant tumor throughout the body leads to the following symptoms:

Unexplained weight loss;
Increased body temperature;
Heartburn and nausea;
Abdominal bloating, increase in its size;
Bloody vaginal discharge.

Main symptoms of ovarian cancer

All these signs are not specific and occur in various diseases. In the initial stages of cancer, they are not detected and are said to be an advanced process.

A distinctive feature of the functional formation of the ovaries is its spontaneous disappearance within 3 months. Often, luteal and follicular cysts go away immediately after the next menstruation. If the formation resolved, it was definitely not cancer, and there was nothing to worry about. If the tumor remains, its removal is indicated. Histological analysis performed after surgery will distinguish a benign process from a malignant one.

Differential diagnostic methods

When the first complaints appear, you need to consult a doctor and undergo an examination:

Gynecological examination

During a bimanual examination, it is easy to confuse a cyst and ovarian cancer. During the examination, the doctor finds a round, mobile formation in the projection of the appendages. At this stage, it is impossible to make an accurate diagnosis and determine the nature of the tumor.

Examination of the lymph nodes is of particular importance in the diagnosis of malignant neoplasms. With an ovarian cyst, the lymph nodes are not enlarged and are painless on palpation. The cancer metastasizes, and the lymph nodes increase in size and lose mobility. It is quite difficult to determine this line clinically. Often, even tumor-affected lymph nodes remain normal in size, which complicates diagnosis. Many structures through which cancer cells metastasize are not at all accessible to palpation.

Pathways of ovarian cancer metastasis.

Laboratory diagnostics

Identifying tumor markers in the blood helps to distinguish a cyst from cancer:

CA-125;
CA-19-9.

CA-125 is detected in 88% of women with ovarian cancer. It grows not only with malignant neoplasms of the appendages, but also with tumors of other localizations. May be increased with endometriosis and inflammation of the appendages.

For your information

Normal CA-125 values do not clearly indicate the benign nature of the process. In stage I ovarian cancer, in half of women the marker remains within normal limits. The results are not very indicative, however, in the absence of other reliable methods, the analysis continues to be used in gynecological practice.

Ultrasonography

Ultrasound allows you to identify a tumor of the appendages, but does not make it possible to determine its cellular structure. The diagnosis is made indirectly based on echographic symptoms. The following signs speak in favor of a malignant process:

Wrong form of education;
Uneven (lumpy) contour of the tumor;
Echo-negative formation with multiple inclusions;
Multilocular tumor with a large number of septa.

The symptoms are not very specific and are not always detected, but can be considered as probable criteria for ovarian cancer. Malignancy is also supported by the appearance of atypical blood flow around the formation and pronounced vascularization of the capsule (according to Doppler results)

The photo below shows two ultrasound images for comparison. The first image shows a hypoechoic ovarian formation without inclusions - presumably a cyst. In the second image, the heterogeneous structure of the formation and the presence of inclusions speak in favor of ovarian cancer:

On a note

A solid or cystic-solid formation of the ovary is not yet a diagnosis, but only an ultrasound sign. A malignant tumor can be either simple or cellular, divided into chambers by partitions.

Ovarian cyst puncture

It is carried out if a cancerous tumor is suspected. Allows you to obtain material for research, but in practice it is not used too often. Damage to the tumor during puncture and aspiration of the contents increases the risk of metastasis and worsens the prognosis of the disease.

Tactics for suspected malignant degeneration of an ovarian cyst

Observation of ovarian cysts is carried out for three months. During this time, functional formations should disappear. Pathological cysts, true tumors and cancer cannot be regressed. Surgical treatment is indicated - removal of the formation with mandatory histological examination after surgery.

It is important to know

If an ovarian cyst is detected, there is no need to refuse surgery. If the formation does not go away within 3 months, it will not go away on its own. A once harmless tumor can quickly develop into cancer, and then it will be too late to operate. It is better to remove a suspicious formation in time than to live in constant fear.

Removal of an ovarian cyst is carried out using laparoscopic or laparotomic access (with an incision in the abdominal wall). Priority is given to minimally invasive operations. Modern technologies make it possible to remove a cyst or the entire ovary through small punctures. Laparoscopic surgery is less often accompanied by the development of complications. Recovery after minimally invasive surgery takes from 7 to 14 days. After 2 weeks, the result of the histological examination will be ready, and the woman will be able to accurately determine the type of tumor and decide on further tactics. The analysis is interpreted by a gynecologist or oncologist.

Schematic illustration of laparoscopic removal of an ovarian cyst.

Indications for removal of an ovarian cyst:

Maintaining education for more than 3 months without a tendency to regression;
Suspicion of ovarian cancer (according to ultrasound and laboratory examination);
Detection of an ovarian tumor in postmenopausal women or in girls before the onset of puberty.

If malignancy is suspected, histological examination of the cyst is performed during surgery. The material is taken to the laboratory, where the histologist on duty gives an opinion within 15-20 minutes. Further tactics will depend on the results of the analysis:

If the formation is benign, it is excised within healthy tissue (cystectomy). If the ovary is significantly damaged, its removal (oophorectomy) is indicated;
For borderline and suspicious formations, the ovary is removed along with the cyst. The ovary is placed in a plastic bag and only then removed. This tactic prevents the spread of cancer cells and tumor metastasis;
If the cyst is malignant, the scope of the operation is expanded. For non-invasive cancer, it is possible to excise only the affected ovary. Stage I cancer or more is an indication for removal of the uterus along with its appendages. Additionally, the greater omentum, appendix, spleen, retroperitoneal lymph nodes – areas of possible metastases – can be removed. In young women, organ-preserving operations are possible only with a thorough examination of the opposite appendages and uterus. After surgical treatment, radiation therapy and chemotherapy are prescribed.

The spread of ovarian cancer depending on the stage of the disease.

It is important to know

Traditional methods of treatment for suspected malignant cysts are not used. In this situation, it is unacceptable to wait - you need to make a diagnosis as soon as possible and get rid of the tumor. Alternative medicine recipes do not eliminate a dangerous disease and are not even considered as an auxiliary method.

Ovarian cysts and tumors are also detected during pregnancy. If malignancy is suspected, the formation must be removed. The operation is performed at 14-20 weeks. The scope of intervention depends on the identified pathology and the stage of pregnancy:

If a cyst or benign tumor is detected, it is removed. The ovary is preserved if possible;
If stage I cancer is detected in the early stages of pregnancy, organ-conserving surgeries can be performed. For cancer stage II and above, removal of the uterus and appendages is indicated. The pregnancy is terminated;
If a malignant ovarian tumor is detected after 22 weeks, a cesarean section is indicated. After the fetus is removed, the extent of the operation will depend on the stage of the cancer.

The prognosis for an ovarian cyst is determined by its type. Benign formations do not pose a threat to life and are easily treatable. When a tumor becomes malignant, the prognosis depends on the stage of the pathological process. The earlier the diagnosis is made, the greater the chance of saving the woman’s life and health.

Interesting video about ovarian tumors and their features

What is ovarian cancer and how is it diagnosed?

Many world oncologists consider cystic and oncological diseases to be identical and interrelated. This is due to the fact that, in accordance with the generally accepted classification of diseases, cysts and inflammatory neoplasms in the ovaries are considered to be abnormal growths that contain a cavity with fluid. At the same time, of course, it is wrong to say that cancer and cysts are the same thing.

In some cases, an ovarian cyst actually turns into cancer if a patient with such a pathology is not seen by a doctor and is not treated. It is worth noting that to identify cysts and tumor neoplasms in modern medical practice, a relatively simple diagnostic method is used - analysis for oncological markers. With the help of such a study, specific protein substances can be found in the patient’s blood, the quantitative content of which can indicate the presence of cancer. The CA-125 marker indicates ovarian cancer. The most interesting thing is that the presence of this marker in the blood of a sick person will indicate both a cyst and oncology.

What are the symptoms of an ovarian cyst?

Like many cancers, an ovarian cyst in the early stages of development will rarely cause severe symptoms. It can manifest itself as a slight deterioration in general condition, loss of appetite and other symptoms that are quite difficult to associate with such a dangerous disease. If the cyst has a leg, then the woman may feel noticeable pain after physical exertion due to its twisting. In addition, the cyst often causes various disruptions during the menstrual cycle.

Also signs of cystic pathology include:

Systematically manifested pain in the lower abdomen (especially felt during physical activity, playing sports, during sexual intercourse).
Nausea, vomiting, bloating.
Increased number of urinations during the day.
Periodic increase in body temperature up to 39 degrees.
Weight gain despite slight loss of appetite.

What is the likelihood of a cyst turning into cancer?

Any woman who has been diagnosed with an ovarian cyst is concerned about the likely progression of the disease to oncology. But before we talk about probability, it should be noted that tumor processes are usually divided into benign and malignant. Ovarian cancer is a malignant process. Taking this into account, experts note that a cyst can indeed develop into a malignant cancer process, but the likelihood of this is quite low from a statistical point of view.

No less noteworthy is the fact that often inexperienced doctors and low-qualified specialists, studying the symptoms and manifestations of the disease and diagnostic test data, mistakenly mistake a malignant cancer process for an ordinary cyst, because in the early stages both diseases manifest themselves almost identically.

Reputable medical literature specifically notes that the likelihood of an ordinary cyst turning into a malignant neoplasm increases as a woman gets older. In other words, a similar process is much more often observed in older people than in young girls. At the same time, doctors clarify that the age-related increase in risks can be neglected, given the low probability that the cyst will develop into ovarian cancer.

If we speak in medical language, then the cyst itself can never develop into a malignant tumor formation. This can happen with an ovarian cyst, which is presented as a benign tumor process.

Ovarian cystoma is a very insidious disease. It can develop in a woman’s body for many years without showing itself in any way. There will be no specific signs or symptoms. And the cystoma itself will never simply turn into a cancerous form - this requires the presence of predisposing factors, many of which are very specific and will depend on the characteristics of the woman’s body.

At the same time, if any predisposing factors appear (for example, the use of hormone replacement therapy), then the likelihood of the cystoma turning into malignant cancer increases significantly with age. At the same time, the transition process itself does not manifest itself in any way. To be fair, it is worth noting that such transitions are extremely rare in modern medical practice.

What else do you need to know?

Despite its similarity in many respects to cancer, an ovarian cyst in women is only in exceptional cases an early stage of the cancer process. Therefore, it will not indicate the presence of a malignant formation. However, under no circumstances should the process be left to chance. If there are any symptoms that indicate the presence of an inflammatory process in the genital organs, then you should immediately consult a doctor who, with the help of special studies, will be able to differentiate the disease.

In modern medical practice, in order to distinguish an ordinary cyst from a cancerous tumor process, the doctor first monitors the growth of the tumor, and then sends the patient for a biopsy. In cases where there is an increase in size of the cyst, this will indicate that it is a tumor, but at a very early stage. An ordinary cystic cavity will never grow in size - it either decreases in size or gradually completely resolves.

If the cyst turns into ovarian cancer, treatment should begin immediately. In this case, the prognosis for many women, regardless of their age, will be quite optimistic.

Modern medicine has made some progress in the treatment of cancer of various locations. But the number of such neoplasms is growing rapidly, and they are not always detected in the initial stages. Among all the oncological processes in gynecology, malignant ovarian tumors are the most insidious, they are difficult to find in time, and they quickly metastasize. Who is at risk for this disease and what symptoms should alert a woman?

Read in this article

Risk factors

No reliable reasons for the development of the disease have been identified. But, based on many years of observations, risk groups have been formed. It is these women who should be more attentive to their health and undergo regular and thorough examinations. The following factors predisposing to ovarian cancer can be identified:

European women are more susceptible to pathology than others. For example, in Japanese women the incidence rate is about 3 per 10 thousand, while in American women it is 20. The difference is significant, but no clear reasons for this have been identified.
Hereditary predisposition plays an undoubted role. Thus, if among close relatives (first and second degree) malignant ovarian diseases have been identified, then the probability in the next generation increases proportionally. Moreover, some “familial cancers” have been identified, including localization in the ovaries. Particular attention is paid to the BRCA-1 and 2 genes, the presence of which in the genome sharply increases the likelihood of malignant tumors of the ovaries and mammary glands.
Age. Most often, neoplasms appear after 40 years; the older the woman, the greater the likelihood. But there is a separate category of malignant ovarian tumors, which is typical only for young girls (for example, germ cell tumors).
Infertility, as well as numerous attempts at IVF, increase the risk of getting sick. And pregnancy, lactation and taking oral contraceptives significantly reduce this likelihood. This is due to the fact that each ovulation leads to intensive cell division in the ovaries. Accordingly, the less often it occurs, the lower the risk. And, according to some data, after just six months of taking contraceptives, the percentage of cases decreases by half - from 1.5 to 0.75%.
Also, any gynecological pathology (various types of dysfunction, chronic inflammatory processes, and others) slightly increases the likelihood of malignant tumors of the genital organs. Patients are also interested in the topic of whether it can be malignant. Of course, but only a histologist can confirm the nature of the formation after removing the structure.

Signs and symptoms

Malignant ovarian tumors may not manifest themselves at all for a long time, this is the whole problem of diseases.

It is not always possible to suspect a disease even during a routine gynecological examination, since the size of the tumor can be no more than 1 cm.

The more pronounced the clinical picture, the higher the stage of ovarian malignancy.

The most common symptoms include the following:

Pain in the lower abdomen. They can be constant or periodic, sharp or aching. They can also be localized both in the lower abdomen and in the sacrum and lumbar region. Sometimes there is a feeling of fullness in this area. When a tumor ruptures or torsion, corresponding symptoms arise - acute, increasing pain in the lower abdomen.
Signs of intoxication are noted: weakness, lethargy, increased fatigue, weight loss.
When adjacent organs are involved in the process, symptoms of their dysfunction appear, for example, constipation or frequent loose stools, constant urge to urinate, etc.
If ascites (effusion in the abdominal cavity) appears, the woman notices an enlargement of the abdomen, and her usual clothes become tight.
If these are hormonally active tumors, the clinical picture depends on what they produce. So, if estrogens, women notice “rejuvenation”, then wrinkles go away, skin tone appears, libido increases, and breasts swell. If there are androgens, then the mammary glands become smaller, hair grows excessively in the area of the lower lip and chin, the white line of the abdomen, and the inner surface of the thighs.

Types of tumors

The classification of malignant ovarian tumors is based on their location, degree of differentiation, and predominant tissue. The following types can be distinguished:

Neoplasms only from epithelial tissue. Among them there are mucinous, serous, endometrioid, clear cell and squamous cell cancer, mixed and undifferentiated tumors.
Formed from epithelial and stromal components.
Neoplasms of the sex cord stroma. Among them are granulosa cell, theca cell and androblastoma.
Lipid cell tumors.
Germ cell neoplasms: malignant teratoma, embryonal carcinoma, dysgerminoma, choriocarcinoma and mixed types.

It is possible to confirm a particular type of tumor only after histological examination. It is rare to guess a variety based on appearance or some other characteristics.

Stages

Correct staging of the disease is extremely important. This affects treatment tactics, further prognosis and other aspects of management of women with similar diseases.

The name of the stage always contains three Latin letters:

T – indicates tumor size;
N – indicates damage to nearby lymph nodes;
M – corresponds to the number of distant metastases.

Next to each letter there is also a digital designation - 1, 2, 3. By summing up all the readings, the stage of the disease is formed.

Based on the size of the malignant ovarian cyst (tumor), the following are distinguished:

T0 – if the primary focus is not determined. This also happens when metastases are found without an underlying tumor.
T1 – if the lesion does not extend beyond the ovaries.
T2 – the process extends to the parametrium.
T3 – the tumor also invades other structures of the pelvis (rectum, bladder, etc.).

If nearby lymph nodes are not affected, then N0 is indicated. In the case when a tumor is detected in them - N1. If there is not enough data to reliably judge this, then “x” is indicated in the index position.

The grades with distant metastases are distributed in a similar way: 0 – there are none, 1 – there are, X – unknown.

In the formulation of the diagnosis, you can see a designation similar to the following: for example, T 1 N 1 M 0, etc.

This classification has parallels with the classical stages. In general terms they can be represented as follows:

Stage 1 – the tumor affects only the ovaries;
Stage 2 – the process extends to the pelvic area;
Stage 3 – there is a tumor and its screenings located nearby;
Stage 4 – with distant metastases and if ascites is associated.

Watch the video about the disease:

Diagnostics

It is not always possible to suspect signs of a malignant ovarian tumor.

But if a woman regularly undergoes gynecological examinations and follows all doctors’ recommendations, the likelihood that she will be diagnosed with cancer at an early stage is high.

General examination in mirrors, bimanual, as well as rectovaginal examination (through the rectum). In this case, it is possible to detect damage to the parametria, tumors of at least 2 - 3 cm.
If necessary, diagnostic curettage of the uterine cavity and cervical canal is performed, as well as puncture of the abdominal cavity through the posterior vaginal fornix. In this case, atypical cells suspicious for cancer can be identified.
, even small formations can be detected.
Proteins specific for tumors of different localizations also help in diagnosis. Their increase directly increases the risk of a malignant process. As for the ovaries, these are CA-125, HE-4, alphafetoprotein, ROMA index, beta-hCG and some others.
Also, a doctor may suspect a tumor even after undergoing a general blood test or biochemical study.

If a neoplasm is diagnosed, the following examinations are performed to determine the extent of the process:

ultrasound examination of the abdominal cavity for the presence of distant metastases;
CT or ;
examination of the gastrointestinal tract and FGDS;
If enlarged lymph nodes are detected, their biopsy is performed.

Treatment

In case of complete confirmation of a malignant ovarian tumor, treatment depends entirely on the stage of the disease. The following main directions are distinguished:

Treatment method	Carrying out
Surgery	Most often, not only the tumor itself is removed, but also the uterus and appendages, as well as the peritoneum, lymph nodes and some other elements. Only in exceptional cases in young and nulliparous women is it possible to preserve reproductive organs in order to realize maternal potential. And even in such situations, in the future, after childbirth, it is recommended to remove the uterus and all associated structures. Most often, surgery is combined with other types of treatment: chemotherapy, radiation. Moreover, such an intervention can be either a primary stage or performed after courses of drug therapy.
Chemotherapy	It is selected taking into account the sensitivity of the tumor to drugs. This treatment has many side effects: nausea, vomiting, hair loss, immune suppression and many others. Therefore, the most effective, but at the same time gentle methods are always chosen. Platinum-based drugs are often used.
Radiation therapy	It is based on the impact of various types of waves on the pelvic organs. In this case, special conductors are often used in order to act as closely as possible on tumor tissues, while minimally damaging healthy ones. Such treatment also has its undesirable consequences in the form of long-term non-healing ulcers, rough scars, etc.

In case of relapse (the appearance of metastases in other organs and structures), additional treatment, correction of the basic regimen, or even more radical methods are indicated.

Forecast

The prognosis for detecting a malignant ovarian cyst largely depends on the treatment performed. The earlier a tumor is detected, the higher the percentage of favorable outcomes for women. On average, the statistics look like this:

if the disease is detected at the first stage, the five-year survival rate is 75 - 90%;
with the second – 55 – 80%;
with the third - 25 - 40%;
with the fourth – about 10%.

Based on this, it is extremely important to detect ovarian tumors in the early stages, which is not always possible for this location.

Prevention

The basis of prevention is identifying risk groups among women and carefully monitoring their health. The main recommendations will be as follows:

Regular examinations by both a gynecologist and a therapist to identify symptoms of a malignant ovarian cyst. An ultrasound examination of the pelvic organs is indicated.
It should also be remembered that pregnancy and lactation due to the physiological absence of ovulation reduce the risk of cancer of the reproductive system.
Women who have used stimulation for follicle maturation throughout their life (during IVF, etc.) should continue to take oral contraceptives. There is a large evidence base that confirms the reduction of risks when using them.
If you have a family history of ovarian or breast cancer, or if you have multiple cancers, you should be tested to detect certain genes, such as BRCA-1 and 2.

Malignant neoplasms of the ovary occur with varying frequencies in different age groups of certain populations. But it is clear that any tumors in the first and second stages have a more favorable prognosis for the quality and life expectancy of women. The responsibility for identifying tumors of any location lies not only with doctors, but also with the fair sex themselves.

The reason for a visit to the doctor may be routine annual prophylaxis or complaints of periodic pain in the lower abdomen. If an ovarian cyst is discovered during examination or after an ultrasound scan, then, first of all, the gynecologist is interested in how benign this formation is: with a greater degree of probability, according to the ultrasound data, a conclusion can be drawn about the nature of the neoplasm, but the final the diagnosis is made only after receiving the results of the histological report.

Using ultrasound, you can make a preliminary diagnosis:

functional (follicular or luteal);
paraovarian;
endometrioid;

However, you can never be sure that a detected ovarian cyst will not turn into malignant over time, so you should listen to the doctor’s opinion and perform a full examination.

Mandatory scope of diagnostics

Using conventional laboratory and hardware diagnostic methods, it is impossible to determine with a 100% guarantee whether an ovarian cyst is benign or malignant. It is possible that an ovarian cystic cavity that has existed for a long time without treatment can become malignant, so studies should be repeated if necessary and according to indications. For each woman, the tumor risk must be predicted individually, taking into account the research results. Mandatory examination methods include:

blood test for tumor markers CA-125, HE-4;
transvaginal ultrasound;
according to indications, CT or MRI is performed;
diagnostic or therapeutic laparoscopy.

In most cases, this is enough to exclude a dangerous diagnosis with maximum confidence. However, it should be understood that any ovarian cyst can become malignant over time, so it is necessary to continue monitoring with a doctor after completion of the examination and treatment.

Ovarian cyst - what is the risk of malignancy

Risk factors for developing ovarian cancer:

the presence of a hereditary predisposition (in the family, relatives had cases of gynecological oncopathology);
frequent medical abortions;
concomitant gynecological diseases caused by hormonal imbalance;
endocrine diseases (metabolic syndrome, obesity, diabetes);
smoking.

The prognosis for the development of a malignant process in the appendage area is individual for each woman, and largely depends on the presence of a genetic predisposition to tumors of the female genital organs.

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Zhumanova Ekaterina Nikolaevna has certificates of an obstetrician-gynecologist, a functional diagnostics doctor, an ultrasound diagnostics doctor, a certificate of a specialist in the field of laser medicine and in the field of intimate contouring. Under her leadership, the laser gynecology department performs about 3,000 operations per year. Author of more than 50 published works, including guidelines for doctors.