When do ovarian cysts become cancerous

Malignant ovarian cysts

Often gynecologists find cysts in their patients' ovaries during routine examinations. There are various methods that can be used to ensure that it is not a malignant tissue change.

Fluid-filled cavities in the ovary

Ovarian cysts are blood or fluid-filled cavities in the ovary. They arise when follicles or corpus luteum in the ovary mature without jumping. Before menopause, ovarian cysts usually regress within a few monthly cycles. The women affected are symptom-free or suffer from unilateral abdominal pain and spotting. If the gynecologist discovers an ovarian cyst, he examines it more closely to rule out confusing it with cancer. Before menopause, only every thousandth ovarian cyst is malignant.

Proof of the Risk Malignancy Index

Malignant ovarian cysts produce the tumor marker CA-125, which can be detected in the patient's blood. In addition, the experts take into account the patient's age and the results of an ultrasound examination. From all these values, they calculate the risk malignancy index, which provides final certainty about the malignancy of an ovarian cyst. The procedure is particularly suitable for postmenopausal women. In women of childbearing age, benign ovarian cysts often also form the tumor marker CA-125.

Proof of the transvaginal ultrasound examination

During the transvaginal ultrasound examination, the gynecologist inserts an ultrasound head into the patient's vagina. He recognizes malignant cysts by their blurred edges and unstructured interior. The assessment requires a lot of experience and knowledge.
Miss Dr. med. Christiane Kähler evaluated the data of over 1300 patients who had undergone ovarian surgery and had previously received a transvaginal ultrasound examination. The transvaginal ultrasound scan identified 75 percent of benign cysts correctly and 97 percent of malignant ones. In contrast, the diagnosis using the Risk Malignancy Index achieved a hit probability of 54 percent for benign tumors and 96 percent for malignant tumors. According to the results of the study, the transvaginal ultrasound examination recognizes benign cysts better than the method according to the Risk malignancy index. "In the end, some women are spared the unfounded fear of fatal cancer and a tissue removal to clarify the suspicion," summarizes Dr. Kähler summarizes the advantages of ultrasound diagnostics. If women are unsure which examination method is right for them, they should contact their gynecologist. Here you will find further information and the best decision support.

Authors

Susanne Schmid / German Society for Ultrasound in Medicine | last changed on at 15:44