Benign Ovarian Masses

Description

Benign ovarian masses are more common in women younger than 40 years of age, whereas the risk of malignancy increases after the age of 50. Benign ovarian masses are classified as functional cysts, hyperplastic lesions, endometriotic cysts, and benign ovarian neoplasms.

Functional cysts develop as a result of ovarian dysfunction or pregnancy-related physiological changes, such as corpus luteum cysts. Hyperplastic lesions are associated with disturbances in neuroendocrine regulation and may have a genetic basis. Endometriotic cysts develop as a consequence of endometriosis, whereas benign ovarian neoplasms arise from proliferating ovarian cells.

Symptoms

Many women are asymptomatic, and the lesion is often detected during a routine gynecological examination. The first manifestation may be menstrual irregularities, including delayed menstruation, amenorrhea, intermenstrual bleeding, or irregular menstrual cycles. Women with multiple ovarian cysts may experience infertility. Endometriotic cysts may cause pelvic pain, brown vaginal spotting outside menstruation, and dyspareunia.

Diagnosis

Diagnosis includes a bimanual pelvic examination, during which adnexal masses may be palpated. Imaging is performed using transvaginal ultrasonography or, when appropriate, transrectal ultrasonography. In girls and women who have not had vaginal intercourse, transabdominal ultrasonography is performed.

Treatment

If polycystic ovary syndrome (PCOS) is diagnosed, treatment includes hormonal contraceptives to regulate the menstrual cycle or surgical treatment in women seeking pregnancy when indicated. For other benign ovarian masses, hormonal contraceptives may initially be prescribed. If the lesion persists or medical treatment is ineffective, surgical removal of the mass is recommended.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology