Ovarian Cysts

Question 1

What structures run through the suspensory ligament?

Answer 1

Ovarian artery
Ovarian vein
Ovarian nerve plexus

Question 2

What are the two broad categories or ovarian cysts?

Answer 2

Functional cysts - caused when the normal cyclic development of follicles is disrupted e.g. follicular cysts, corpus luteum cyst

Question 3

How do follicular cysts form?

Answer 3

The dominant follicle fails to rupture meaning the normal LH surge doesn’t happen, meaning the follicle continues to grow.

Question 4

How do corpus luteum cysts form?

Answer 4

When the dominant follicle ruptures but then closes up again after ovulation, meaning the corpus luteum does not dissolve and continues to grow

Question 5

Why are corpus luteum cysts also called haemorrhagic cysts?

Answer 5

The arteries nourishing the cysts can rupture and haemorrhage into the cyst.

Question 6

Which functional cysts are also called simple cysts?

Answer 6

Follicular and corpus luteum

Question 7

What causes theca luteum cysts?

Answer 7

Overstimulation from betaHCG, which stimulates the growth of follicular theca cells. ONLY SEEN IN PREGNANCY, occurs bilaterally

Question 8

When are theca luteum cysts more likely to develop?

Answer 8

When there is more betaHCG, for example:
Multiple fetuses
Gestational trophoblastic disease

Question 9

What are the types of neoplastic cysts?

Answer 9

Ovarian tumours

Question 10

Benign ovarian tumours

Answer 10

Serous cystadenoma
Mutinous cystadenoma
Mature cystic teratomas

Question 11

Malignant ovarian tumours

Answer 11

Serous or Mucinous cystadenocarcinomas - develop from surface ovarian epithelium

Question 12

Complications of ovarian cysts

Answer 12

1. Haemorrhage - most common with follicular and corpus luteal
2. Rupture - contents released into peritoneal cavity. Can happen spontaneously but frequently occurs after sex
3. Ovarian torsion - ovary twists around susoensory ligament and cuts of blood supply

Question 13

What are the symptoms of ovarian cysts?

Answer 13

Dull, aching lower abdominal pain
Dyspareunia
Feeling of pressure - frequent urination or bowel movement

Question 14

What could sudden severe abdominal pain indicate?

Answer 14

Ovarian torsion
Ruptured cyst
Haemorrhage

Question 15

What could upper abdominal or shoulder pain indicate?

Answer 15

Blood in the subphrenic space of peritoneal cavity due to rupture

Question 16

How is an ovarian cyst diagnosed?

Answer 16

Abdominal ultrasound, may need an MRI is diagnosis uncertain

Histological analysis after collection of cysts cell by ultrasound guided aspiration or following removal of the cyst

Question 17

What blood test may be done to rule out a malignant ovarian tumour?

Answer 17

Ca-125