Ovarian cysts: types

Question 1

Ovarian cysts: types

Answer 1

Benign ovarian cysts are extremely common. They may be divided into
-physiological cysts,
-benign germ cell tumours,
-benign epithelial tumours and
-benign sex cord stromal tumours.

Complex (i.e. multi-loculated) ovarian cysts should be biopsied to exclude malignancy.

Physiological cysts (functional cysts)
-Follicular cysts
-Corpus luteum cyst

Follicular cysts:
commonest type of ovarian cyst
due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle
commonly regress after several menstrual cycles

Corpus luteum cyst:
during the menstrual cycle if pregnancy doesn’t occur the corpus luteum usually breaks down and disappears. If this doesn’t occur the corpus luteum may fill with blood or fluid and form a corpus luteal cyst
more likely to present with intraperitoneal bleeding than follicular cysts

Benign germ cell tumours

Dermoid cyst
also called mature cystic teratomas.
Usually lined with epithelial tissue and hence may contain skin appendages, hair and teeth
most common benign ovarian tumour in woman under the age of 30 years
median age of diagnosis is 30 years old
bilateral in 10-20%
usually asymptomatic. Torsion is more likely than with other ovarian tumours

Benign epithelial tumours
-Serous cystadenoma
-Mucinous cystadenoma

Arise from the ovarian surface epithelium

Serous cystadenoma
the most common benign epithelial tumour which bears a resemblance to the most common type of ovarian cancer (serous carcinoma)
bilateral in around 20%

Mucinous cystadenoma
second most common benign epithelial tumour
they are typically large and may become massive
if ruptures may cause pseudomyxoma peritonei