Ovarian tumors
Benign ovarian tumors are formations on the ovaries that are the result of a violation of the process of growth, division, and differentiation of cells. Pathological tumor cells have properties that are not characteristic of normal cells, in particular: endless division, aggressive growth with spread to surrounding tissues, violation of the antigenic composition. These cell modifications are called tumor conversion (transformation). The clinical manifestations of a tumor are foci of pathological tissue in different parts of the body. Benign ovarian tumors are a very relevant topic today. The ovaries are paired organs that are located on both sides of the uterus. The classification of ovarian tumors includes benign, malignant and borderline (with a low level of malignancy) neoplasms.
The content of the article:
Types of benign ovarian tumors
Causes of benign ovarian tumors
Symptoms of ovarian tumors
Methods of diagnosis of benign ovarian tumors
Treatment of benign ovarian tumors
Prevention of the appearance of benign ovarian tumors
Ovarian tumors
The formation of benign tumors differs from malignant ones, the first ones do not grow beyond the outlines of the ovaries, therefore, with the help of surgical intervention, a complete recovery of the patient can be achieved.
Types of benign ovarian tumors
There are four types of benign ovarian tumors: epithelial tumors, neoplasms of the stroma of the genital cord, tumors of the germinogenic plan and various tumor-like processes. In turn, epithelial tumors include serous, endometrioid, mucinous, mixed epithelial, mesonephroid (light-cell), as well as a benign Brenner tumor. Neoplasms of the stroma of the genital cord include androblastoma, fibroma and tecoma. Germinogenic tumors are dermoid cysts and ovarian struma. Tumor-like processes include many pathologies, including multiple follicular cysts, single follicular cyst, corpus luteum cyst, multiple luteinized and yellow bodies, simple cysts, superficial epithelial inclusions, endometriosis, paraovarial cysts, inflammatory processes, hyperthecosis, ovarian stroma hyperplasia and massive ovarian edema.
There are morphological differences between the first three types (hemoroidal tumors, epithelial tumors, neoplasms of the genital stroma) and tumor-like processes, although they are visually similar to each other. Violation of the complex process of embryonic development of the ovary causes the existing variety of ovarian tumors. Unfortunately, ovarian tumors are quite common. For example, 12% of all intracavitary surgical interventions are surgical interventions to remove ovarian tumors. Most often, dermoid cysts develop, as well as serous and mucinous cystadenomas.
Causes of benign ovarian tumors
There are a number of etiological factors contributing to the development of ovarian tumors, but the exact cause of their occurrence has not been established. Risk factors that provoke the appearance of benign ovarian tumors are considered to be early or late menopause, genetic predispositions, early or late onset menarche (first menstruation), infertility, various kinds of menstrual dysfunction, inflammation of the uterine appendages, uterine fibroids, endometriosis. As for epithelial tumors, the risk of their appearance increases with the age of a woman. Women suffering from various endocrine diseases (diabetes mellitus, obesity, thyroid dysfunction) are more likely to be at risk of developing mucinous ovarian tumors.
Symptoms of ovarian tumors
As a rule, in the early stages, benign ovarian tumors develop without any symptoms. With mucinous tumors, symptoms appear later than with others. Tumor growth can be clinically manifested by pain in the lower abdomen, a significant increase in its volume, as well as violations of defecation and urination. Violation of the function of urination and defecation occurs due to the pressure of the tumor on nearby organs. In post- and premenopause, the presence of ovarian tumors is often manifested by abundant hemorrhages, more often in the presence of hyperestrogenism. Ovarian fibroma can be accompanied by Meigs syndrome, that is, the presence of ascites, hydrothorax and anemia.
Methods of diagnosis of benign ovarian tumors
The diagnosis of ovarian tumors is divided into several stages, the first of these stages is a bimanual examination. If a bimanual examination revealed suspicions of the presence of ovarian tumors, proceed to the next stage — ultrasound examination of the ovaries. But most often it is very difficult to identify benign ovarian tumors, the reason for this is the absence or weak severity of clinical manifestations. Therefore, do not neglect the planned annual gynecologist examinations.
The final stage of the diagnosis of benign ovarian neoplasms is a histological examination (taking a piece of tumor tissue for analysis). More often, the markers CA-19 and CA-125 (tumor markers) are determined. Histological examination is a very important element in differentiating the diagnosis, as it allows you to distinguish a benign ovarian tumor from a malignant tumor, which further contributes to the correct choice of treatment tactics. Sometimes there is a need for diagnostic laparoscopy and in many cases such manipulation develops into a therapeutic one.
Treatment of benign ovarian tumors
The main and most productive method of treating benign ovarian tumors is the surgical method. In the presence of a diagnosis of “benign ovarian tumor”, complete removal of the affected ovary is more often performed or partial removal of the ovary is resorted to — adnexectomy. The decisive factors in determining the treatment tactics are the reproductive status, age and histological type of the disease. With bilateral localization of ovarian tumors, especially during perimenopause, a pangistectomy is performed.
To date, most doctors prefer the laparoscopic method of access to benign ovarian tumors. This method minimizes surgical trauma, reduces the risk of adhesive processes, complications of thromboembolism in the postoperative period, and also helps to facilitate rehabilitation and improve reproductive potential.
There are cases of diagnosing benign ovarian tumors in pregnant women, fortunately, such pathologies occur in no more than 0.4% of pregnant women. During pregnancy, the risk of complications of benign ovarian tumors increases. Such complications of tumor growth include twisting of the tumor leg, termination of pregnancy, violation of the integrity of the tumor shell, as well as a mechanical obstacle to the advancement of the fetal head through the birth canal during childbirth.
The main indications for surgical treatment of benign ovarian tumors during pregnancy are the presence of a tumor-like formation or ovarian tumor exceeding ten centimeters in diameter. Surgical interventions are performed in the first or second trimester of pregnancy. Carrying out any surgical interventions during pregnancy is to comply with the basic rules of surgery — any risk during surgical treatment should not exceed the risk of endangering the health of the mother and fetus in case of non-operation.
Prevention of the appearance of benign ovarian tumors
The main reason for the neglected course of this pathology is its weakly expressed, latent development. But there are experts who believe that the frequent cause of neglect of benign ovarian tumors is not symptom-free, but on the contrary, lulling attention to an already diagnosed tumor. With scheduled visits to the doctor, a properly collected anamnesis and preventive measures, the risk of neglect of the disease is significantly reduced. According to the data collected with the help of medical statistics, all patients who were diagnosed with a benign ovarian tumor had more or less pronounced symptoms.
It is not for nothing that the issues of improvement and reformation of methods of preventive examinations and the search for new ways to prevent the formation of benign ovarian tumors have been raised more and more often in information sources lately.
It is important to monitor the hormonal balance, consult a doctor in time and take all necessary measures to normalize the hormonal background. In many cases, pathological changes are suppressed after pregnancy and childbirth. It is not for nothing that the appearance of benign tumors occurs in women over the age of 30 and more often have not given birth.
It is important not to forget that any tumor, even benign, can turn into malignant if you do not follow the doctor’s recommendations in time.
