Pelvic masses can arise from ovaries, fallopian tubes, uterus or non-gynecologic pelvic organs. A large number of pelvic masses arise from the ovaries and can be due both to non-cancerous conditions such as ovarian cysts or due to cancer. The suspicion for cancer and need for surgery depends on the woman’s age, symptoms, family history and various characteristics of the mass or cyst itself.
What are ovarian cysts?
Ovarian cysts are little sacs of fluid that form on or in a woman’s ovary. Each woman has 2 ovaries, one on each side of her belly. In women who are still having their monthly period, the ovaries release an egg about once a month.
Ovarian cysts can cause pain or a feeling of pressure in the belly. Or women might not feel them at all. Many women worry about cancer when they learn they have cysts. But most of the time, cysts are not cancer.
What are the symptoms of ovarian cysts?
Many women have no symptoms. When symptoms do happen, they can include pain or pressure in the lower belly on one side. The pain can be dull or sharp, and it can come and go.
Sometimes, an ovarian cyst breaks open or causes the ovary to twist. This can be a serious problem. Call your doctor right away or go to the emergency room if you feel intense pain in the lower belly on either side that doesn’t go away. For example, you should go to the emergency room if you have sudden pain that makes you double over or that makes it hard for you to walk and the pain doesn’t go away. Along with the pain, you might also feel nauseous or throw up, or have light bleeding from your vagina.
What causes ovarian cysts?
There are many possible causes of ovarian cysts. The most common causes include:
Ovulation or pregnancy
Ovulation is when an egg is released from the ovary each month. For this to happen, the ovary grows a sac, called a “follicle.” Sometimes, a follicle grows but does not release an egg and instead forms a cyst. Or, if a woman gets pregnant after the egg is released, a cyst can stay on the ovary for weeks or months. These kinds of cysts are not harmful and usually go away on their own.
Dermoid cysts
These are a common type of cyst. They sometimes have teeth, hair, or fat in them. That might sound strange. Dermoid cysts are normally not harmful to your health, but your doctor might want to remove them with surgery.
Polycystic ovary syndrome (also called PCOS)
In women with this condition, the ovary grows many small cysts, instead of one big follicle that goes away each month. These cysts usually do not go away, but the cysts themselves do not need to be treated or removed. PCOS does sometimes require treatment for reasons unrelated to the cysts.
Endometriosis
Endometriosis is a condition where tissue normally found in a woman’s uterus grows outside of the uterus. Endometriosis can also form cysts on the ovary. Women with endometriosis might have belly pain during their periods or at other times, pain in the belly during sex, or trouble getting pregnant.
Cancer
Cancer is the cause of ovarian cysts in less than 1 in 100 cases. Ovarian cancer is most likely to affect older women who have been through menopause (no longer have a monthly period) or who have a family history of ovarian cancer.
Dr. Gorelick uses a comprehensive testing program that includes both imaging and bloodwork to determine which patients are at risk of cancer. One of the advantages of having Dr. Gorelick perform your pelvic mass surgery is that in the unlikely case cancer is discovered, the appropriate surgical procedure will be performed at the same time without the need to have a second surgery at a later point since Dr. Gorelick is an experienced gynecologic cancer surgeon.