In modern gynecology, benign ovarian tumors are an urgent problem. Every year the disease only "gets younger." Both young girls and women of old age are equally affected by it. The lack of quality treatment can lead to disastrous consequences, including death.
Benign and malignant ovarian tumors
A tumor is an overgrowth of pathologically deformed cell tissues. The latter are formed from elements of various origins, perform many functions. Tumors are always bulky formations. As for the female reproductive system, in this case the pathological process first begins to develop in the organs themselves. Then it can move to neighboring structures, conquering more and more new areas.
Given the changes in the cells, all neoplasms of this area are usually divided into two groups: malignant and benign ovarian tumors. Such a classification is conditional. During the reproductive period, some benign formations are transformed into malignant. 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 individual healthy cells. All this inevitably entails the germination of pathological elements into the lymphatic vessels, further spread throughout the body along with blood flow. As a result, multiple metastases are formed. Histologically malignant cells differ in their structure from healthy areas of the ovary. In appearance, they are very diverse, because they are constantly at different stages of development.
Benign formations are limited from neighboring tissues by the membrane, never go beyond it. However, they differ in their ability to increase in size, which sometimes leads to compression of neighboring organs. Such elements do not destroy healthy tissues, do not show a tendency to metastasis. After surgical removal almost always comes complete recovery. Cases of relapse are extremely rare.
Features of the benign process
The ovaries are considered the most important organ of the reproductive system. Sex hormones are produced in them, the eggs mature. On the other hand, they quite often act as targets 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. A benign ovarian tumor does not leave the limits of the affected organ, which allows you to get rid of the disease in a timely manner. The main treatment method is surgery.
Among other features of such formations, doctors distinguish the following:
- Formation at any age.
- Decreased female reproductive potential.
- Lack of specific symptoms.
- A high risk of malignancy is transformation into a malignant tumor.
Most often, women after 30 years undergo a pathological process. It is characterized by an asymptomatic course. This is silent cancer. Its name obliges every woman to closely monitor her health and periodically undergo examination by a gynecologist.
For example, inflammation of the appendages in acute form always causes tangible pain. This makes the lady go to the doctor, at the reception of which a dangerous disease is detected. In other cases, extremely rarely 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 disease remains without attention and is actively developing.
Causes of pathology
The etiology of benign ovarian tumors is unknown. Doctors continue to discuss this issue, making various assumptions. For example, doctors managed to identify a whole group of provocative factors. Their direct impact significantly increases the likelihood of developing a pathological process. These factors include:
- hormonal disorders;
- continuous ovulation;
- genetic predisposition;
- violation of the process of maturation of follicles;
- taking progesterone;
- smoking.
Pregnancy can also trigger the development of a benign process.
Clinical picture
Most often, in the early stages, severe symptoms of a benign ovarian tumor are absent. As education grows, the clinical picture changes. Typically, women come to the gynecologist with the following complaints:
- Drawing pains in the lower abdomen, characterized by a one-sided character.
- Infertility.
- Violation of the female cycle.
- Constant feeling of heaviness in the lower abdomen.
- Dysuric disorders.
- Problems with bowel movements, increased abdominal volume due to flatulence.
The last two manifestations of the disease are a 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, characterized by a benign nature, are capable of producing hormones. As a result, the disease may be accompanied by the following health problems:
- prolonged absence of menstruation;
- clitoral enlargement;
- breast size reduction;
- the development of acne;
- excess male body hair;
- Cushing's syndrome.
Such symptoms can appear at absolutely any age, including during pregnancy.
Signs of the disease with torsion of the legs of the tumor
A somewhat different symptom is characterized by the complicated course of a benign ovarian tumor in women. The most common manifestation of it is considered to be torsion of the neoplasm. It can appear in benign and borderline conditions. The structure of the surgical leg includes nerves, blood vessels, the fallopian tube, the area of the peritoneum and the ligament of the uterus. In case of malnutrition of the 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. With partial torsion of the legs, their severity is much less. They can disappear on their own and reoccur.
Pathology classification
In modern gynecology, all neoplasms are usually divided into groups and subgroups. There are many classifications of benign ovarian tumors, each of which takes as its basis a specific symptom. For example, the World Health Organization offers the following separation options:
- Epithelial tumors: serous, mucinous, endometrioid, clear cell, etc.
- Neoplasms of the stroma of the genital cord: tecom, fibroma, androblastoma.
- Germ cell tumors: dermoid cysts, ovarian struma.
- Tumor-like processes: multiple follicular cysts, superficial epithelial inclusions, endometriosis, stromal hyperplasia, hypertosis, etc.
However, in practice, the most commonly used division of the pathological process into two categories: tumor-like formations and superficial (epithelial) ovarian tumors. Distinctive features of each of the two groups will be discussed below.
Tumor-like formations
This category of benign ovarian tumors includes:
- Follicular cyst. Most often diagnosed in young girls. A cyst develops in only one ovary, is characterized by high mobility and elasticity. Its diameter can vary from 2.5 to 10 cm. Pathology is manifested by a violation of the female cycle. Usually, its development is accompanied by a delay in menstruation with subsequent severe bleeding. After 3-6 cycles, the cyst disappears on its own. It is not prone to malignancy, but requires control. After identification, continuous monitoring is recommended.
- Cyst of the corpus luteum. The size of the neoplasm can vary within 3-6.5 cm. Clinically, it manifests itself as a violation of menstruation, scanty spotting from the vagina, and engorgement of the mammary glands. The corpus luteum cyst is sometimes perceived as pregnancy. With the help of ultrasound, you can consider its structure. The presence of single / multiple septa, blood clots is not excluded. There may be a gap in education after the next sexual intercourse.
- Serous cyst. Prior to histological analysis, pathology is often mistaken for a follicular cyst. There are suggestions of a possible malignancy, but they have not been proven in practice. The serous cyst develops from the remains of the primary germinal kidney. It represents a mobile elastic formation, the size of which does not exceed 10 cm. Most often, a tumor is detected after torsion of its legs.
Treatment of patients with benign ovarian tumors begins only after determining the nature and type of pathology.
Epithelial neoplasms
This is the largest group, which accounts for about 70% of all benign ovarian neoplasms. Tumors develop from the stroma and superficial epithelium of the organ. Usually they are one-sided. On palpation, they do not differ in pain, but are characterized by mobility and elastic consistency. The bilateral nature of the pathology is considered as a suspicion of malignancy.
Border tumors deserve special attention. These are serous, mucous, mixed and other types of formations. After surgery, the likelihood of relapse is not ruled out. According to 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 quite problematic. Especially in the early stages when there are no obvious signs of a pathological process. Many experienced gynecologists can identify neoplasms by palpation. The help of this method must be resorted to during the inspection.
If a pathology is suspected, the patient is prescribed an ultrasound of the pelvic organs. The best option is transvaginal ultrasonography with color Doppler. This is an informative examination method that allows you to determine the structure and size of the tumor. Additionally, a blood test is prescribed to determine the markers CA-19 and CA-125. With its help, the probability of malignancy is revealed.
The final stage of diagnosis is a histological examination, during which the doctor takes samples of tumor tissue. After studying the material in the laboratory, we can accurately talk about the benign or malignant process.
Features of the therapy
The main treatment for benign ovarian tumors is surgery. The treatment plan and the scope of the operation are selected individually. In this case, the doctor must take into account the patient's age, her desire to maintain fertility. An important role in this matter is played by the nature of the neoplasm.
Today, most specialists prefer laparoscopic surgery. Benign ovarian tumor is not 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 quite quickly.
If laparoscopy is not possible, an ovariectomy is prescribed. This operation involves the 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, the treatment of benign ovarian tumors in this way is carried out in extreme cases. With bilateral localization of the pathological process, a panhisterectomy is performed - an operation in which the uterus is removed with appendages.
Sometimes tumors are diagnosed in pregnant women. Fortunately, such a pathology is rare and accounts for only 0.4% of cases. The main indication for surgery 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 neoplasm is detected in most cases, the doctor insists on its removal. The reason for this decision is the high probability of complications. What problems can a woman face?
- Malignization of the pathological process. This is the most dangerous complication of a benign ovarian tumor. A timely operation allows us to hope for a full recovery. If the neoplasm was diagnosed in a neglected form, and treatment was started too late, the probability of its transformation into malignant is 30-50%. In this case, the tumor has the ability to germinate in neighboring tissues and organs. Mutated elements can spread throughout the body, causing irreversible cancer processes.
- Capsule rupture. This problem is always accompanied by severe pain, bleeding and shock. Quickly enough, the contents of the capsule enter the abdominal cavity. As a result, aseptic peritonitis develops. Such a complication requires immediate surgical intervention. Otherwise, the likelihood of adhesions increases, which jeopardizes the woman's ability to become pregnant.
- Torsion of the legs of the tumor. This complication of a benign ovarian tumor always develops unexpectedly. Often it is preceded by a sharp movement of the body or physical activity. Torsion itself contributes to the violation of trophism in the tumor. Pathology is accompanied by acute pain. The skin becomes pale, and the pulse noticeably quickens. Torsion of the legs of the tumor requires an emergency operation. Otherwise, the likelihood of necrosis of formation, the development of a secondary infection in the body increases.
The listed complications are considered the most common.
Prevention Methods
The main reason for the neglected course of pathology is considered latent development. To date, specific measures for its prevention have not been developed. However, regular preventive examinations by a gynecologist with parallel ultrasound diagnostics allow timely detection and prevention of a possible malignancy of a benign ovarian tumor.
Clinical recommendations of doctors on the prevention of the disease also come down to periodic monitoring of the hormonal background. This applies to all women who have reached reproductive age. If necessary, you need to consult a doctor and follow his instructions to normalize the balance.