What is the cause of ovarian cystic mass?

Ovarian cystic solid masses may be caused by physiological cysts, endometriosis, teratomas, cystadenomas or ovarian cancer. Ovarian cystic solid mass refers to an abnormal structure with both liquid and solid components in the ovarian tissue. The nature needs to be clarified through ultrasound and other examinations.

1. Physiological cyst

Luteal cysts formed after ovulation or follicular cysts formed when the follicles have not ruptured are physiological changes and usually appear as an echoless area on one side of the ovary, mostly less than 5 cm in diameter. This type of cyst may be accompanied by changes in the menstrual cycle, and some patients will experience a slight feeling of bloating in the lower abdomen. Most of them will disappear on their own after 2-3 menstrual cycles. No special treatment is required, and regular ultrasound examinations are enough.

2. Endometriosis

Ectopic endometrium can form chocolate cysts during periodic ovarian bleeding. There is old blood accumulation in the cyst, and ultrasound shows dense punctate echoes in the cyst. Patients often have progressively worsening dysmenorrhea, dyspareunia, and infertility, which may be related to reflux of menstrual blood or immune abnormalities. Drugs such as dienogest tablets and ibuprofen sustained-release capsules are commonly used clinically to relieve symptoms. In severe cases, laparoscopic cyst removal is required.

3. Teratoma

Mature teratoma is the most common ovarian germ cell tumor. The cyst may contain tissue such as grease, hair or teeth, and appears as a mixed echo mass on ultrasound. The tumor is mostly benign and grows slowly, but it may twist the pedicle and cause an acute abdomen. After diagnosis, surgical resection is recommended, and laparoscopic ovarian cyst removal can be selected to preserve normal ovarian tissue.

4. Cystadenoma

Serous or mucinous cystadenoma is an ovarian epithelial tumor with papillary protrusions attached to the cyst wall and thin or viscous cyst fluid. Patients may be asymptomatic or may only feel abdominal pain. When the tumor is large, an abdominal mass may be palpable. Ultrasound examination shows multilocular cysts with septations, which need to be differentiated from borderline tumors. After diagnosis, an appendectomy on the affected side should be performed.

5. Ovarian cancer

Malignant tumors such as serous cystadenocarcinoma can manifest as cystic-solid masses. Ultrasound shows thick walls, septations, and rich blood flow. They are often accompanied by ascites and elevated CA125. The onset may be related to BRCA gene mutation or continued ovulation. Early symptoms are insidious, and late symptoms include weight loss, abdominal distension, etc. Treatment requires cytoreductive surgery combined with chemotherapy such as paclitaxel injection and carboplatin injection according to the stage.

After discovering a solid ovarian cystic mass, tumor markers and imaging examinations should be completed, and strenuous exercise should be avoided to prevent cyst rupture or pedicle torsion. Keep your vulva clean every day, eat a balanced intake of high-quality protein and fresh vegetables and fruits, and control a high-fat diet. Women over the age of 40 are recommended to have annual gynecological examinations. If new cysts or masses grow rapidly after menopause, they need to be alert to the possibility of malignancy and seek immediate medical attention from a gynecologist or oncologist.