Benign tumor of the ovaries: diagnosis, symptoms, treatment

In modern gynecology, benign ovarian tumors are an actual problem. Every year the disease only "gets younger". He is equally exposed to both young girls and women of advanced age. Lack of quality treatment can lead to disastrous consequences, including death.

Benign and malignant tumors of the ovaries

A tumor is a proliferation of pathologically deformed cellular tissues. The latter are formed from elements of different origins, perform many functions. Tumors are always bulky structures. As for the female reproductive system, in this case the pathological process first begins to develop in the organs themselves. Then he can move to neighboring structures, conquering all new areas.

Given the changes taking place in the cells, all neoplasms of this area are divided into two groups: malignant and benign ovarian tumors. This classification is conditional. During the reproductive period, some benign tumors are transformed into malignant ones. However, they have a lot of differences.

Tumors of a malignant nature are characterized by a rapid growth rate and the ability to penetrate into separate healthy cells. All this inevitably entails the germination of pathological elements in the lymphatic vessels, further spread along the body along with the blood flow. As a result, multiple metastases are formed. Histologically, malignant cells differ in their structure from healthy areas of the ovary. By their appearance they are very diverse, because they are constantly at different stages of development.

Benign formations are bounded from neighboring tissues by a shell, never go beyond it. However, they differ in the ability to grow in size, which sometimes leads to compression of neighboring organs. Such elements do not destroy healthy tissues, do not show a tendency to metastasize. After surgical removal, there is almost always a complete recovery. Cases of recurrence are extremely rare.

Features of a benign process

Ovaries are considered the most important organ of the reproductive system. They produce sex hormones, mature eggs. On the other hand, they quite often act as a target for various pathological processes. Cysts and various neoplasms among all organs of the reproductive system usually choose the ovaries. They are considered a vulnerable structure. Benign tumor of the ovaries does not leave the limits of the affected organ, which allows you to get rid of the disease in time. The main method of treatment is operative intervention.

Among other features of this kind of education doctors distinguish the following:

1. Formation at any age.
2. Decreased female reproductive potential.
3. Absence of specific symptoms.
4. The high risk of malignancy is transformation into a malignant tumor.

Most often the pathological process is experienced by women after 30 years. It is characterized by an asymptomatic course. This is a "silent cancer". Its name obliges every woman to closely monitor their health and periodically undergo examination with a gynecologist.

For example, the inflammation of the appendages in an acute form always causes appreciable pain. This causes the lady to see a doctor, whose admission reveals a dangerous disease. In other cases, it is extremely rare that there are pulling sensations in the lower abdomen. Therefore, the cancer process can be confused with an intestinal disorder or diseases of the uterus. As a result, the ailment remains without attention and is actively developing.

Causes of pathology

The etiology of benign ovarian tumors is unknown. Physicians continue to debate on this issue, expressing various assumptions. For example, doctors managed to identify a whole group of provocateur factors. Their direct effect significantly increases the likelihood of the development of the pathological process. Such factors include:

• Hormonal disorders;
• Continuous ovulation;
• Genetic predisposition;
• Violation of the process of maturation of follicles;
• Taking progesterone;
• smoking.

Pregnancy can also provoke the development of a benign process.

Clinical picture

Most often in the early stages of the expressed symptoms of a benign ovarian tumor are absent. As the education grows, the clinical picture changes. Usually women come to see a gynecologist with the following complaints:

1. Drawing pains in the lower abdomen, characterized by a one-sided nature.
2. Infertility.
3. Violation of the female cycle.
4. Constant sensation of heaviness in the lower abdominal cavity.
5. Dysuric disorders.
6. Problems with defecation, an increase in the volume of the abdomen due to flatulence.

The last two manifestations of the disease are rare, but at the same time an early sign of even a small tumor. Women themselves and even doctors practically do not attach any importance to it.

Some types of cystic formations, which are benign in nature, are capable of producing hormones. As a result, the disease can be accompanied by the following health problems:

• Prolonged absence of menstruation;
• Increased clitoris;
• Decrease in the size of the mammary glands;
• Development of acne;
• Excess body hair of the male type;
• Cushing's syndrome.

Such symptoms can appear absolutely at any age, including during pregnancy.

Signs of the disease when the tumor is twisted

Several other symptoms are characterized by a complicated course of benign ovarian tumor in women. The most common manifestation of it is considered to be the torsion of the foot of the neoplasm. It can appear with benign and borderline conditions. The surgical leg consists of nerves, vessels, fallopian tube, a site of the peritoneum and a ligament of the uterus. When eating a tumor, the following symptoms occur:

• Sudden unilateral pain in the lower abdomen, which sometimes becomes permanent;
• Vomiting and nausea;
• Bloating;
• Sticky sweat;
• Pallor of the skin;
• Fever.

The listed signs of violation are not permanent. When the legs are partially twisted, their severity is much less. They can disappear on their own and arise again.

Classification of pathology

In modern gynecology, all neoplasms are divided into groups and subgroups. There are many classifications of benign ovarian tumors, each of which takes as a basis a certain attribute. For example, the World Health Organization offers the following separation options:

1. Epithelial tumors: serous, mucinous, endometrioid, light-celled, etc.
2. Neoplasms of the stroma of the genital tract: tekoma, fibroma, androblastoma.
3. Germinogenic tumors: dermoid cysts, ovarian duct.
4. Tumor processes: multiple follicular cysts, superficial epithelial inclusions, endometriosis, stromal hyperplasia, hypertension, etc.

However, in practice, the division of the pathological process into two categories is most often used: tumor-like formations and superficial (epithelial) ovarian tumors. The distinctive features of each of the two groups will be discussed below.

Tumor formation

This category of benign ovarian tumors includes:

1. The follicular cyst. Most often it is diagnosed in young girls. The cyst develops only in one ovary, characterized by high mobility and elasticity. Its diameter can vary from 2.5 to 10 cm. Pathology manifests itself in violation of the female cycle. Usually, its development is accompanied by a delay in menstruation followed by severe bleeding. After 3-6 cycles, the cyst disappears on its own. It does not tend to be malignant, but it requires control. After detection, continuous monitoring is recommended.
2. Cyst of the yellow body. The size of the neoplasm can vary within 3-6.5 cm. Clinically, it manifests itself as a violation of menstruation, scant bloody discharge from the vagina, engorgement of the mammary glands. A yellow body cyst is sometimes perceived as a pregnancy. Using ultrasound, you can consider its structure. The presence of single / multiple partitions, blood clots is not excluded. Possible disruption of education after another sexual intercourse.
3. Serous cyst. Before carrying out a histological analysis, pathology is often mistaken for a cyst follicular. There are suggestions of possible malignancy, but they have not been proven in practice. Serous cyst develops from the remains of the primary embryonic kidney. It represents a flexible elastic formation, the size of which does not exceed 10 cm. Most often, the tumor is detected after the torsion of its pedicle.

Treatment of patients with benign ovarian tumors begins only after determining the nature and variety of pathology.

Epithelial neoplasms

This is the most numerous group, which accounts for about 70% of all benign neoplasms of the ovaries. Tumors develop from the stroma and superficial epithelium of the organ. Usually they are one-sided. When palpation is not characterized by pain, but characterized by mobility and elastic consistency. The bilateral nature of the pathology is seen as a suspicion of malignancy.

Particular attention deserves borderline tumors. These are serous, mucous, mixed and other types of formations. After surgery, the likelihood of a relapse is not excluded. According to the studies, borderline tumors belong to the category of pathologies of a low degree of malignancy. Most often they are diagnosed in young women at the initial stages of development.

Medical Examination

Diagnosis of benign ovarian tumors is problematic enough. Especially in the early stages, when there are no obvious signs of a pathological process. Many experienced gynecologists can determine neoplasms through palpation. The help of this method must be resorted to during the examination.

If a patient is suspected of having a pathology, the ultrasound of the pelvic organs is prescribed. The best option is transvaginal ultrasonography with color Doppler research. This is an informative method of examination, allowing to determine the structure and size of the tumor. Additionally, a blood test is performed to determine the CA-19 and CA-125 markers. With its help, the probability of malignancy is revealed.

The final stage of the diagnosis is histological examination, during which the doctor takes samples of tumor tissue. After studying the material in the laboratory, you can accurately talk about the good or malignancy of the process.

Peculiarities of the therapy

The main method of treating benign ovarian tumors is surgical intervention. The treatment plan and the scale of the operation are selected individually. In this case, the doctor must take into account the age of the patient, her desire to preserve the childbearing function. Not the least role in this matter is the character of the neoplasm.

To date, most specialists prefer laparoscopic surgery. Benign tumor of the ovary is not yet a sentence. With timely access to medical care, it is possible to maintain reproductive function. This method of intervention is characterized by a low risk of complications, and the rehabilitation period passes quickly enough.

If laparoscopy is not possible, oophorectomy is prescribed. This operation implies a complete removal of the ovary with a localized neoplasm. It is worth noting that resection significantly increases the risk of infertility in the future. Therefore, treatment of benign ovarian tumors in this way is carried out in extreme cases. When bilateral pathology is localized, panthistectomy is performed - an operation in which the uterus is removed from the appendages.

Sometimes neoplasms diagnosed in pregnant women. Fortunately, such a pathology is a rarity and is only 0.4% of cases. The main indication for the operation during pregnancy is a benign ovarian tumor more than 10 cm in diameter. Surgical intervention is carried out only in the I or II trimester.

Possible complications

If a tumor is found, in most cases the doctor insists on removing it. The reason for this decision is a high probability of complications. What problems can a woman face?

1. Malignization of the pathological process. This is the most dangerous complication of benign ovarian tumor. A timely operation allows you to hope for a full recovery. If the neoplasm was diagnosed in neglected form, and the treatment is started too late, the probability of its degeneration into malignant is 30-50%. In this case, the tumor has the ability to germinate into neighboring tissues and organs. Mutated elements can spread throughout the body, causing irreversible cancerous processes.
2. Capsule rupture. This problem is always accompanied by a sharp pain, bleeding and shock. Quickly the content of the capsule enters the abdominal cavity. As a result, aseptic peritonitis develops. This complication requires immediate surgical intervention. Otherwise, the likelihood of an adhesion process increases, which jeopardizes a woman's ability to become pregnant.
3. Torsion of the legs of the tumor. This complication of a benign tumor of the ovaries develops always unexpectedly. Often it is preceded by a sharp movement of the body or physical activity. The torsion itself contributes to trophic disruption in the tumor. Pathology is accompanied by acute pain syndrome. The skin becomes pale, and the pulse is noticeably more frequent. Torsion of the legs of the tumor requires an emergency operation. Otherwise, the probability of necrosis of formation, the development of secondary infection in the body increases.

These complications are considered the most common.

Methods of prevention

The main reason for the neglected course of pathology is concealed development. To date, no specific measures for its prevention have been developed. However, regular preventive examinations at the gynecologist with parallel ultrasound diagnosis allow timely detection and prevention of possible malignancy of a benign ovarian tumor.

Clinical recommendations of doctors on the prevention of the disease also reduce to periodic monitoring of the hormonal background. This applies to all women of fair sex who have reached reproductive age. If necessary, you need to consult a doctor and follow his instructions for normalizing the balance.