What are The Causes of Ovarian Cysts?

Ovarian cysts are examples of adnexal mass. Adnexal mass means present of abnormal growth or mass within the pelvis which usually involves the reproductive organs and structures. Adnexal mass is a famous gynecologic issue. American women have a 5-10% risk to undergo surgery due to ovarian tumours. Any women of any age are at risk to have adnexal mass. There are two types of adnexal mass. They are gynaecologic or non-gynaecologic mass. Gynaecologic can affect the fallopian tubes, ovaries, or other surrounding gynecologic structures. Non-gynaecological can affect structures from the digestive or urinary system such as ureter, bladder, and intestines. Ask to doctor for ovarian cysts for a better understanding of gynaecological issues.

It is challenging for doctors to detect the structures affected and the underlying cause for a particular case with adnexal mass as there are many adnexal masses. History taking, physical examination, and investigations are compulsory to establish a diagnosis. However, in cases due to adnexal mass, surgical intervention is usually needed to confirm a diagnosis. History taking and physical examination are important in signs and symptoms analysis. Investigations are important to provide enough evidence to conclude a diagnosis. Two conditions that doctors will exclude before telling you are having an adnexal mass are:

  • Emergency and life-threatening conditions
  • Cancer

The examples of emergency and life-threatening conditions are adnexal torsion and ectopic pregnancy. The examples of cancer are ovarian cancer and fallopian tube cancer. The clinical presentations of emergency or life-threatening conditions are:

  • Bleeding in the first trimester
  • Severe pain
  • Fever

Surgical interventions and pelvic ultrasound are needed to conclude that a patient is suffering from cancer of the adnexal structures. The examples of ovarian masses are:

  • Ovarian cancer
  • Metastatic disease
  • Physiological cyst-like corpus luteum
  • Benign ovarian growth like an endometrioma

The examples of fallopian tube masses are:

  • Hydrosalpinx
  • Ectopic pregnancy
  • Cancer of the fallopian tube

Children and adolescents are less likely to develop adnexal mass. If thy develop one, the most possible causes are either adnexal torsion or cancer of the ovaries. The most common type of ovarian cancer among them is a germ cell tumour. Pregnant women are also at risk to develop adnexal mass. The common adnexal masses among pregnant women are :

  • Corpus luteum cyst
  • Ectopic pregnancy
  • Luteomas
  • Theca lutein cysts

The common adnexal mass among postmenopausal women are:

  • Ovarian cancer
  • Fallopian tube cancer
  • Tubo-ovarian abscess
  • Adnexal torsion

The imaging that can be done to analyze an adnexal mass is:

  • Pelvic ultrasound
  • Transvaginal ultrasound
  • Transabdominal ultrasound
  • Magnetic resonance imaging (MRI)

Other investigations are:

  • Pregnancy test
  • Full blood count
  • Test to detect cancer biomarkers
  • Surgical exploration
  • Histopathological analysis

The treatment of adnexal mass depends on the site and the underlying causes. Surgery can be done if malignancy is suspected and there is no other risk related to the mass. The adnexal mass can be resected or if it is an ovarian mass, ovarian cystectomy and oophorectomy can be done. Surgical exploration for an adnexal mass can be done laparoscopically or via open surgery. If a mass is highly suspected as either fallopian tube cancer, ovarian cancer, or peritoneal cancer, opinion and assessment from a gynecologic oncologist are required. Such cases will be referred straight to them. Ask to doctor for a better understanding of other gynaecological issues.

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