Types of ovarian cysts and pelvic masses
Ovarian cysts may be described as simple or complex based on their appearance on ultrasound.
Simple cysts are usually benign and may resolve without treatment. Complex cysts contain features such as internal divisions, solid areas or other findings that require closer assessment.
Pelvic masses may arise from conditions including functional ovarian cysts, endometriosis, dermoid cysts, benign ovarian tumours and uterine fibroids. Less commonly, they may represent borderline ovarian tumours or cancer.
The appearance of a mass on imaging, together with symptoms and other clinical factors, helps determine whether monitoring, further investigation or surgery is appropriate.
Symptoms
Some ovarian cysts and pelvic masses cause no symptoms and are discovered incidentally during imaging for another reason.
When symptoms occur, they may include:
- Pelvic or abdominal pain or pressure
- Abdominal bloating or swelling
- Changes in urinary frequency or bowel habits
- A feeling of fullness or discomfort
Sudden, severe pelvic pain requires urgent medical assessment, as it may indicate complications such as ovarian torsion or cyst rupture.
Tests and assessment
Assessment usually involves reviewing your symptoms, medical and family history, and previous investigations.
Pelvic ultrasound is the main investigation used to assess the size and appearance of a pelvic mass. A repeat or specialist ultrasound may be recommended if further characterisation is needed.
Blood tests, including CA-125 and other tumour markers where appropriate, can provide additional information. An elevated CA-125 does not necessarily indicate cancer, and a normal result does not exclude malignancy.
MRI or CT imaging may be recommended in selected circumstances to better characterise a mass or assess for possible spread of disease.
Treatment
Management depends on the appearance and size of the mass, symptoms, age, menopausal status and individual circumstances.
Monitoring: Some cysts and masses can be safely monitored with repeat imaging, particularly when the likelihood of malignancy is low.
Surgery: Surgical removal may be recommended when a mass is suspicious, persistent, symptomatic or increasing in size.
Surgery may be performed using minimally invasive laparoscopic or robotic techniques, or through an open abdominal incision, depending on the characteristics of the mass and the suspected diagnosis.
Where malignancy is a concern, surgery is planned to minimise the risk of tumour rupture or spillage and allow appropriate treatment if cancer is identified.
For younger patients, preservation of ovarian tissue and fertility is considered wherever clinically appropriate.
Specialist assessment
Dr Shaun McGrath provides assessment and treatment of both straightforward and complex ovarian cysts and pelvic masses.
Management is individualised and may involve reassurance and monitoring, further investigations or surgery where appropriate.
Shaun's subspecialty training in gynaecological oncology also provides expertise in assessing masses with features concerning for malignancy and planning surgery when the diagnosis is uncertain.
Common questions
Does a complex ovarian cyst mean I have cancer?
No. Many complex ovarian cysts are benign. Their significance depends on the ultrasound findings and other clinical factors.
Will I need surgery?
Not necessarily. Some cysts and masses can be monitored safely, while others require removal because of their appearance, size or associated symptoms.
Can my ovary be preserved?
Ovarian preservation may be possible, particularly in younger patients. This depends on the nature of the mass, the risk of malignancy and individual circumstances.
Do I need a referral?
Yes. A referral from your GP or specialist is needed for a Medicare rebate. Please address this to Dr Shaun McGrath at Arc Specialist Care.
Further information and support
Seeing us in Brisbane
Ask your GP or specialist for a referral to Dr Shaun McGrath at Arc Specialist Care, then call us to book.
This information is general in nature and does not replace individual medical advice. Investigation and treatment recommendations depend on your specific circumstances.