In modern gynecology, benign ovarian tumors are an actual problem. Every year the disease only "gets younger". Both young girls and older women are equally affected by it. Lack of quality treatment can lead to disastrous consequences, including death.
Benign and malignant ovarian tumors
A tumor is a proliferation of pathologically deformed cellular tissues. The latter are formed from elements of various origins, perform many functions. Tumors are always voluminous. 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 the new areas.
Given the changes taking place in the cells, all neoplasms in this areaIt is customary to subdivide into two groups: malignant and benign tumors of the ovaries. This classification is conditional. During the reproductive period, some benign formations are transformed into malignant ones. However, they have a lot of differences.
Tumours of a malignant nature are characterized by a rapid growth rate and the ability to penetrate individual he althy cells. All this inevitably entails the germination of pathological elements in the lymphatic vessels, further spread throughout the body along with the blood flow. As a result, multiple metastases are formed. Histologically, malignant cells differ in their structure from he althy parts of the ovary. In their appearance, they are very diverse, because they are constantly at different stages of development.
Benign formations are limited from adjacent tissues by the shell, 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 he althy tissues, do not show a tendency to metastasize. After surgical removal, there is almost always a complete recovery. Relapses are extremely rare.
Features of a benign process
The ovaries are considered the most important organ of the reproductive system. They produce sex hormones, eggs mature. 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 systemusually choose the ovaries. They are considered vulnerable structure. A benign ovarian tumor does not leave the affected organ, which allows you to get rid of the disease in a timely manner. The main method of treatment is surgery.
Among other features of this kind of formations, doctors distinguish the following:
- Formation at any age.
- Decrease in female reproductive potential.
- No specific symptoms.
- High risk of malignancy - transformation into a malignant tumor.
Most often, women over 30 are exposed to the pathological process. It is characterized by an asymptomatic course. This is "silent cancer". Its name obliges every woman to closely monitor her he alth and periodically undergo an examination by a gynecologist.
For example, acute inflammation of the appendages always causes significant pain. This makes the lady go to the doctor, at whose reception a dangerous disease is revealed. In other cases, pulling sensations in the lower abdomen are extremely rare. Therefore, the cancerous process can be confused with an intestinal disorder or diseases of the uterus. As a result, the disease remains unattended and actively develops.
Causes of pathology
The etiology of benign ovarian tumors is unknown. Physicians continue to discuss this issue, expressing various assumptions. For example, doctors managed to identify a whole group of factors provocateurs. Their direct impact significantly increases the likelihood of developing pathologicalprocess. 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, there are no pronounced symptoms of a benign ovarian tumor. As education grows, the clinical picture changes. Usually women come to the gynecologist with the following complaints:
- Drawing pains in the lower abdomen, characterized by one-sided character.
- Infertility.
- Violation of the female cycle.
- Persistent feeling of heaviness in the lower abdomen.
- Dysuric disorders.
- Problems with bowel movements, 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 may be accompanied by the following he alth problems:
- prolonged absence of menses;
- clitoris enlargement;
- breast reduction;
- development of acne;
- excessive male body hair;
- Cushing's syndrome.
Such symptoms can appear at absolutely any age, including during pregnancy.
Signs of the disease when the pedicle of the tumor is twisted
Several other symptoms are characterized by a complicated course of a benign ovarian tumor in women. The most common manifestation of it is the torsion of the legs of the neoplasm. It can appear in benign and borderline conditions. The structure of the surgical leg includes nerves, vessels, fallopian tube, peritoneal area and uterine ligament. If the tumor is malnourished, 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;
- increased body temperature.
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 reappear.
Classification of pathology
In modern gynecology, all neoplasms are usually divided into groups and subgroups. There are many classifications of benign ovarian tumors, each of which is based on a certain symptom. For example, the World He alth Organization suggests the following split options:
- Epithelial tumors:serous, mucinous, endometrioid, clear cell, etc.
- Stromal neoplasms of the sex cord: thecoma, fibroma, androblastoma.
- Germ tumors: dermoid cysts, ovarian struma.
- Tumor-like processes: multiple follicular cysts, superficial epithelial inclusions, endometriosis, stromal hyperplasia, hyperthecosis, 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-like formations
This category of benign ovarian tumors includes:
- Follicular cyst. Most often diagnosed in young girls. The cyst develops only in 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, followed by heavy bleeding. After 3-6 cycles, the cyst disappears on its own. It is not prone to malignancy, but requires control. Once identified, ongoing surveillance is recommended.
- Cyst of the corpus luteum. The size of the neoplasm can vary between 3-6.5 cm. Clinically, it is manifested by a violation of menstruation, scanty bloody discharge from the vagina, and engorgement of the mammary glands. A corpus luteum cyst is sometimes mistaken for pregnancy. Ultrasound can be used to seestructure. The presence of single / multiple partitions, blood clots is not excluded. Possible rupture of education after the next sexual intercourse.
- Serous cyst. Before histological analysis, the pathology is often mistaken for a follicular cyst. There are suggestions about possible malignancy, but they have not been proven in practice. The serous cyst develops from the remnants of the primary germinal kidney. It is a mobile elastic formation, the size of which does not exceed 10 cm. Most often, the tumor is detected after the 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, accounting for about 70% of all benign ovarian neoplasms. Tumors develop from the stroma and superficial epithelium of the organ. Usually they are unilateral. 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.
Borderline tumors deserve special attention. These are serous, mucous, mixed and other types of formations. After surgery, the possibility of recurrence is not ruled out. According to studies, borderline tumors belong to the category of low-grade pathologies. They are most often diagnosed in youngwomen in the early 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 the pathological process. Many experienced gynecologists can identify neoplasms through palpation. This method must be used during the inspection.
If a pathology is suspected, the patient is prescribed an ultrasound of the pelvic organs. Transvaginal ultrasonography with color Doppler is considered the best option. 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, you can accurately talk about the benignity or malignancy of the process.
Features of the therapy
The main treatment for benign ovarian tumors is surgery. 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 maintain childbearing function. Not the least role in this matter is played by the nature of the neoplasm.
Today, most specialists prefer laparoscopic surgery. A benign ovarian tumor is not yet a verdict. With timely seeking medical help, it is possible to maintain reproductive function. This method of intervention is characterized by a low risk of complications, and the rehabilitation period is quite fast.
If laparoscopy is not possible, an oophorectomy is indicated. 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 panhysterectomy is performed - an operation in which the uterus is removed with appendages.
Sometimes neoplasms are diagnosed in pregnant women. Fortunately, this pathology is rare and accounts for only 0.4% of cases. The main indication for surgery during pregnancy is a benign ovarian tumor larger than 10 cm in diameter. Surgical intervention is carried out only in the 1st or 2nd trimester.
Possible Complications
When a neoplasm is detected, in most cases, the doctor insists on its removal. The reason for this decision is the high likelihood of complications. What problems can a woman face?
- Malignancy of the pathological process. This is the most dangerous complication of a benign ovarian tumor. Timely operation gives hopefor a full recovery. If the neoplasm was diagnosed in an advanced form, and treatment was started too late, the probability of its transformation into a malignant one is 30-50%. In this case, the tumor has the ability to grow into neighboring tissues and organs. Mutated elements can spread throughout the body, causing irreversible cancerous processes.
- Rupture of the capsule. This problem is always accompanied by severe pain, bleeding and shock. Quite quickly, the contents of the capsule enter the abdominal cavity. As a result, aseptic peritonitis develops. This complication requires immediate surgical intervention. Otherwise, the likelihood of an adhesive process increases, which jeopardizes the woman's ability to become pregnant.
- Torsion of the pedicle 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. The torsion itself contributes to the disruption of trophism in the tumor. Pathology is accompanied by acute pain syndrome. The skin becomes pale, and the pulse noticeably quickens. Torsion of the tumor stem requires emergency surgery. Otherwise, the likelihood of necrosis of the formation increases, the development of a secondary infection in the body.
The listed complications are considered the most common.
Prevention Methods
The main cause of the neglected course of pathology is considered to be latent development. On theTo 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 possible malignancy of a benign ovarian tumor.
Clinical recommendations of doctors for the prevention of the disease also come down to periodic monitoring of hormonal levels. This applies to all the fair sex who have reached reproductive age. If necessary, you need to consult a doctor and follow his instructions to normalize the balance.
