Ovarian Serous Cystadenoma
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Phew! What are these terms? It must be a big disease, for sure.
Take a deep breath and calm down. Let us make some sense of these terms separately to help you understand the condition better.
Terms you need to know about
- Ovarian: A condition that is related to the ovary or ovaries. You already know that there are two ovaries on each side of the uterus. They hold the eggs and produce reproductive hormones like estrogen and progesterone.
- Serous: The term serous means fluid, which is either thin and watery or thicker and mucous-like.
- Cyst: A cyst is a sac or pouch filled with fluid or semisolid material. In this case, the cyst is filled with watery or mucous-like fluid and is hence, of serous type.
- Adenoma: An adenoma is a non-cancerous swelling or benign tumor. In this case, it is formed from the cells on the surface of either one or both ovaries
What is an ovarian serous cystadenoma?
To sum it all up, we can say that ovarian serous cystadenoma is a non-cancerous type of ovarian tumor with a cyst containing thin, watery fluid that develops from the cells (epithelium) on the surface of the ovary. It is commonly seen on one ovary, but about 10–20% of the cases involve both ovaries.
Most ovarian cysts form in response to the hormonal changes in the body during periods and tend to go away on their own. But sometimes, cysts that form are not linked to hormonal changes due to menstruation. Usually, these cysts are not harmful but may need long-term monitoring.
Cystadenomas are one such type of cyst. They are not related to hormonal changes. Scientists and doctors are not yet aware of any direct causes for their formation.
- Ovarian serous cystadenomas represent 16% to 20% of all ovarian epithelial tumors.
- They are the most common kind of benign ovarian epithelial tumor.
- They occur in women during childbearing years and even after menopause. They are seen most commonly in women aged 40 to 50.
Types of cystadenomas seen in the ovaries
- They may be serous (filled with watery fluid), called serous cystadenomas, or mucinous (filled with mucous-like fluid), called mucinous cystadenomas.
- The two other types of ovarian cystadenomas, endometrioid and clear cell cystadenomas, are rare.
Can they become cancerous?
What is important to note, and it should put you at ease, is that the tumor has no mutations and is mostly not cancerous.
- Mutations, like KRAS or BRAF, are found in serous carcinomas and mucinous cystadenomas. They are also linked to diseases like colorectal cancer and mucinous cystadenomas.
- There is no connection between serous cystadenomas of the ovary and those of the pancreas. The risk of an ovarian cystadenoma does not increase if a person has pancreatic cystadenoma, and vice versa.
- Although most serous cystadenomas of the ovaries are non-cancerous, there is a minor chance that they may become cancerous later, especially if the cysts are large. The risk is also higher after menopause.
What symptoms should you be aware of?
- Small ovarian cystadenomas of sizes 1–3 cm.
- Tend to be painless and harmless.
- Since they usually do not cause symptoms, healthcare providers usually find them during a routine pelvic exam, ultrasound, or CT scan.
- 2. Large ovarian serous cystadenomas are usually about 10 cm in size but may grow larger than 30 cm.
- 3. These large cysts press or displace neighboring organs, like loops of the bowel, and may cause symptoms such as
- Dull or sharp pain in the pelvic region, especially during certain activities
- Bloating
- The feeling of heaviness in the lower abdomen (abdominal discomfort)
4. Some patients with ovarian cystadenoma may be unable to pass urine and/or distended bladder problems. This may confuse the doctor into believing the condition is related to the urinary bladder rather than the ovaries and delay diagnosis.
- Rare complications like ovarian torsion are linked to very large cysts. They displace and twist the ovary from its place and decrease its blood flow. The twisting can cause sudden, sharp pain.
- A cyst may rupture, causing bleeding and severe, sudden pain.
- Ovarian cysts are common during pregnancy and continue to grow. They may require constant monitoring by the gynecologist.
You are advised to schedule regular pelvic exams and talk to your doctor about any symptoms that you may be experiencing for an early diagnosis.
How will your doctor diagnose the cyst?
- Your doctor may find smaller cysts by chance while doing pelvic examinations, ultrasounds, CT, or MRI scans for some other concern.
The doctor will
- Take your medical and family histories into account.
- Do a physical examination, including a pelvic exam.
- Recommend an ultrasound or CT scan
2. Transvaginal ultrasound, color Doppler, CT scans, or vaginal MRI are needed to confirm the size and nature of the cysts.
- The cysts appear round and smooth, filled with clear or straw-colored liquid. They may be unilocular or multilocular.
3. Blood investigations to confirm the diagnosis include: cancer antigen 125 (CA-125), carcinoembryonic antigen (CEA), beta hCG levels, alpha-fetoprotein (AFP), cancer antigen (CA19-9), and lactate dehydrogenase (LDH).
4. Routine investigations are also done before going for surgery.
5. The entire tumor is removed surgically and studied by a pathologist under a microscope (histopathological examination). The pathologist then confirms the diagnosis of a serous cystadenoma.
6. Another method of diagnosis is when a surgeon consults a pathologist during surgery. The pathology results may change the type of surgery and future treatment.
How is it treated?
Many methods of treatment are available. Your gynecologist will choose the treatment depending on the cyst size, whether you plan to get pregnant, your family history of breast or ovarian cancer, etc.
- Most small cysts do not require any surgery, but the doctor will closely monitor them for changes. This method is called watchful waiting. During this period, ultrasounds are repeated regularly to monitor changes in the cyst.
- The doctor may advise surgery for larger cysts that may be causing major discomfort and other symptoms or may turn cancerous.
- The procedure where only the cyst is removed is called cystectomy.
- The method by which the entire ovary is surgically removed is called oophorectomy.
- The doctor may also recommend removing the fallopian tubes and uterus (hysterectomy) at the same time in some cases.
- The surgeries are usually non-invasive (laparoscopic) and are done by making small incisions. They take less time to heal, and the patients are usually discharged within 3 days.
- The pungentLarge cysts and those suspected of cancer may require open surgeries. smell of urine
Conclusion
Most serous cystadenomas of the ovaries are non-cancerous tumors with an excellent prognosis if managed well by a team of experienced gynecologists, radiologists, and pathologists.
If you have any concerns or symptoms related to ovarian serous cystadenomas, it would be best to contact a gynecologist. They will provide personalized advice and recommend the best treatment plan for your situation.