Multiple small liquid inclusions. Benign tumors and tumor-like formations of the ovaries

Hello! I'm 24, not married. Back in September I was diagnosed with a right ovarian cyst. I took Jess+ for 3 months. Before the New Year, the doctor stopped coke. Recently my side started to hurt, and a local gynecologist checked it and said it was fine. I decided to play it safe and did a TVUS (on the 9th day of mammary cycle), and here are the results of the ovaries: right - dimensions 35 * 18 * 26 mm, structural with follicles max 9.5 mm, plus fluid inclusion with suspension 10 mm (endrometriosis? old corpus luteum?) left - 37*18*29 mm, structural with follicles max 5 mm, plus a similar liquid inclusion with an irregularly shaped suspension 18*9 mm. Please tell me what causes these liquid inclusions to form? aren't they dangerous? and how to treat them? Should we be afraid? (otherwise I read it here on the Internet)

Hello, Gulnaz.
The size of your ovaries is within normal limits, they function functionally: there are follicles and corpus luteum. It is necessary to review the dynamics of the cycle, on days 5-7 of the next cycle.
And liquid inclusions are the growing follicles or the corpus luteum.
But, in my opinion, the COC should have been prescribed for a longer period - 6-9 months.

After undergoing an ultrasound, some women discover that the ovary contains a fluid formation. In such cases, it is not always necessary to sound the alarm, because this kind of cyst often goes away on its own along with the next monthly cycle.

Such formations cause danger if:

• Pain after and during sexual intercourse;
• Nagging pain during physical activity;
• Nausea, etc.

In this case, we can talk about the development of the tumor and the need for its detailed examination. It should be said that a fluid formation in the left or right ovary is typical for women after forty years of age, but can be detected at any age.

Causes of neoplasms in the ovary

Such neoplasms are quite common, but it is still quite difficult to study the nature of their occurrence. However, we can definitely say that fluid formation in the ovary is a consequence of hormonal imbalance. The nature of this failure can be either pathogenic, caused by the body itself, or artificial, arising as a result of taking hormonal drugs.

Regardless of the cause of the pathology, it needs further examination and study, otherwise the following consequences may be observed:

• Risk of uterine cancer;
• Hair loss;
• Infertility;
• Swelling;
• Pain;
• Obesity.

Diagnosis and treatment of formations in the ovary

Basic examinations carried out when a fluid formation in the left ovary is suspected are limited to ultrasound and blood tests for hormonal levels. This approach allows you to obtain general data about the condition of the body and prescribe further therapy. For the most part, in women with this pathology, the menstrual cycle and ovulation are disrupted, first of all, the reproductive and then other human systems suffer.

If the body is prone to the occurrence of neoplasms, then stress, lifestyle, poor nutrition, non-compliance with work and rest schedules, etc. can push it to develop abnormalities. If you have a follicular cyst or fluid formation in the right ovary, you should immediately seek help from specialists.

When you are concerned about the manifestation of certain symptoms of the disease or it is discovered that the ovary contains a fluid formation after an ultrasound examination, then you need to make an appointment with a specialist.

The ovaries in women are paired organs that are responsible for ovulation and also secrete the necessary female hormones. Like other pelvic organs, the ovaries require regular examination, for which ultrasound examination may be performed.

Often the conclusion of a pelvic ultrasound is a fluid formation in the right or left ovary. What it is, interests women. This formation is called a cyst; it is a cavity, most often a follicle, filled with fluid. Do not be alarmed, this condition may not require treatment, but you should definitely consult a gynecologist.

Liquid formations can have different sizes, sometimes they are very large, up to 10-15 cm in diameter. Such formations occur mainly in women of reproductive age, and in the vast majority of cases they resolve on their own, and the patient is not even aware of their appearance.

There are several types of liquid neoplasms in the ovary:

• Corpus luteum cyst.
• Follicular cyst.
• Paraovarian tumors;
• Mucinous tumors.

All types of fluid formations can become malignant, especially mucinous tumors, so they require specialist supervision. If the formation grows and causes discomfort to the woman, it must be removed. In addition, a bubble with fluid may burst, then all the fluid with blood will flow into the abdominal cavity, causing inflammation.

Causes

A fluid formation in the right or left ovary can appear in any woman or girl, regardless of what kind of sex life she leads, whether she has given birth, etc. Most often, fluid accumulation is associated with failure during ovulation.

Normally, every month an egg matures on the ovary inside a follicle, which bursts on the day of ovulation. But sometimes a malfunction occurs, then fluid forms in the follicle, which provokes the formation of a cyst.

Liquid formation can form against the background of hormonal imbalances, infectious diseases, and endocrine pathologies. Multiple fluid formations are called polycystic; this condition occurs due to endocrine disorders and causes infertility.

There are also a number of negative factors that increase the risk of cysts:

• promiscuity;
• untreated infections;
• hypothermia;
• weak immunity;
• poor nutrition, vitamin deficiency;
• passive lifestyle.

All these factors have a bad effect on the body as a whole, and can provoke not only the appearance of fluid formation, but also many other serious disorders.

Symptoms

In most cases, women do not even suspect that they periodically develop fluid formations in the ovaries, because they may not be accompanied by any symptoms. In such cases, the cyst appears on its own and resolves after a couple of menstrual cycles.

Unfortunately, this does not always happen. If the cyst does not resolve, it gradually increases in size; this often happens if the formation is accompanied by adnexitis, that is, inflammation of the appendages. Then the patient complains of the following symptoms:

• pain in the lower abdomen during the cycle;
• painful periods;
• pain during intercourse;
• copious whitish discharge;
• Irregular menstruation.

If the liquid formation reaches large sizes, then the following may occur:

• spotting in the middle of the cycle and bleeding;
• bloating;
• nausea;
• increased body temperature;
• infertility due to lack of ovulation.

The cyst can burst, for example, during sexual intercourse or physical activity, in which case a sharp pain appears in the lower abdomen, which in intensity can even be compared to appendicitis. Sometimes this process is accompanied by bleeding from the vagina, but not always. Sharp, unbearable pain is a reason to call an ambulance. You can’t take painkillers in the hope that everything will go away on its own. Rupture of the cyst can result in serious complications.

Treatment

How the liquid formation will be treated depends on its size and type. Most often, therapy is not required at all; the woman is prescribed to undergo examination after a while to assess whether the cyst is resolving or not.

To make the formation go away faster, hormonal medications, as well as anti-inflammatory and painkillers, and vitamins can be prescribed. Most often, a woman is prescribed oral contraceptives. Physiotherapeutic treatment is also indicated in complex therapy.

If the cyst continues to grow after a course of therapy, has an impressive size and causes pain, surgery will be required. Urgent surgery is indicated if there is a risk that the formation may develop into ovarian cancer or rupture.

Modern surgical treatment is carried out using laparoscopy, which does not leave large scars on the skin and does not require long-term rehabilitation.

Complications

Fluid formation in the ovary is a serious finding that requires treatment. If a woman decides to neglect going to the doctor, then she should be prepared for the following complications.

• Ovarian cancer. This complication does not occur often, but there is still a small risk of malignancy of the cyst.
• Ovarian apoplexy or rupture with hemorrhage. This disorder is quite severe; it provokes internal bleeding with large blood loss, which is life-threatening.
• Peritonitis is inflammation of the peritoneum. This condition can occur as a result of a cyst rupture. The pathology very often ends in death.
• Torsion of the cyst stalk is accompanied by severe pain and can provoke necrosis of the cyst. If the pathology is not treated, it causes infertility and increases the risk of ectopic pregnancy.
• A large cyst can cause intestinal obstruction.

As a rule, such complications arise in cases where treatment was not started in a timely manner. If you remove the cyst before complications appear in the general manner, then most likely there will be no consequences. Emergency cyst removal is often accompanied by the removal of the entire ovary and even the fallopian tube in some cases, which significantly reduces the chances of conceiving in the future.

The appearance of liquid contents in the ovaries is called a cyst. Let's try to figure out what it is. A cyst is a bubble filled with fluid. It is rarely diagnosed in mature women, since the occurrence of the tumor is associated with the active production of female hormones.

This formation on the genital organ has several varieties. Most often, women are diagnosed with a corpus luteum cyst. It is located on one side of the ovary. A characteristic feature of a corpus luteum cyst is its thick walls. The cavity of the formation contains a yellow liquid. Sometimes the fluid contains blood. Corpus luteum cyst appears as a result of ovulatory failure. If, after fertilization of the egg, cells enter the follicle, it begins to grow and accumulate fluid.

A follicular cyst forms inside the genital organ. Its walls are formed from the follicle. This type of formation appears as a result of hormonal imbalance. Such benign tumors rarely reach large sizes. Their growth is directed towards the peritoneum.

Paraovarian tumors are formed from the appendages and are located above the ovary. They have a rounded shape. Inside such a cyst there is a colorless liquid. The walls of the tumor are so thin that blood vessels can be seen. Such cysts most often appear in women of reproductive age. They can grow up to 11 centimeters in diameter without damaging the genitals.

Mucinous tumors contain mucus inside. These formations usually consist of several chambers and reach large sizes (up to 15 centimeters in diameter). According to statistics, mucinous tumors often develop into malignant ones. The fluid contents of dermoid cysts often contain fragments of connective tissue or embryonic cells.

Why does fluid appear in the ovary?

The appearance of fluid in the ovaries in women is due to a number of reasons. Most often, this pathology appears in women due to malfunctions of the genital organs. During ovulation, the vesicle must rupture, and its liquid contents, along with the egg, enter the peritoneum. If this does not happen, the walls of the bubble stretch, and a large amount of liquid accumulates in it. This process in the ovaries ends with the formation of a cyst.

If a woman develops several blisters filled with fluid, this is called multiple cystosis. This pathology occurs in the patient due to the prolonged course of the inflammatory process. Inflammation of the ovaries can occur as a result of hypothermia. If a woman also has a weakened immune system, the disease develops with complications.

Important! Kidney diseases very often provoke the appearance of fluid in the ovary. As a result, stagnation appears in the pelvis. Impaired blood supply and functioning of the genital organs also lead to the formation of cysts.

Liquid contents appear due to hormonal imbalances. In this case, the patient needs to restore hormonal balance with the help of medications carefully selected by the gynecologist. Endocrine disorders and malfunctions of the thyroid gland also affect the functioning of the ovaries. At risk are patients who started their periods too early or late, as well as women who have had multiple abortions.

Sometimes the presence of free fluid in the ovary is accompanied by endometriosis. This disease is accompanied by the growth of the endometrium beyond the boundaries of the uterus. If the patient has been diagnosed with this, it is first necessary to eliminate the disease itself and the cause of its occurrence.

Diagnosis and treatment

You are unlikely to be able to independently diagnose the presence of fluid in the ovaries, since this phenomenon does not cause any complaints. In rare cases, you may notice minor pain in the lower abdomen, as well as an increase in the duration of menstruation. If you feel severe stabbing pain, you need to see a doctor immediately. This sign often appears when the tumor stalk twists around its axis.

Only an experienced gynecologist can determine the presence of fluid in the ovary. To begin with, he will refer you for an ultrasound examination of the pelvic organs. If your doctor finds a cyst, he will order you to take a test to check your blood hormone levels. In some cases, an accurate diagnosis can only be made using laparoscopy. During this diagnosis, the surgeon makes several small incisions through which he inserts an optical device called a laparoscope. This device transmits an enlarged image of the ovary to a special screen. Thus, the doctor has the opportunity to view your appendages in an enlarged form.

If the disease occurs due to hormonal imbalance, your treatment will be carried out by an endocrinologist. Most often, he prescribes oral contraceptives, which will help normalize hormonal levels. If the pathology is caused by an inflammatory process, your inflammation will be eliminated first. In this case, physiotherapy is an effective treatment method. Doctors often prescribe additional antibiotics and vitamins.

Note: If doctors suspect a tumor is malignant, they will remove it urgently. To do this, incisions are made in the navel area. When the tumor reaches catastrophic proportions, you will undergo abdominal surgery. This surgical intervention consists of complete removal of the ovary or incision of the peritoneal wall.

The key to effective treatment is timely diagnosis. If you regularly visit a gynecologist, you will be able to find out about the occurrence of a cyst at the initial stage, when it has not yet had time to increase in size.

Complication

If free fluid is detected in the ovary, the patient must undergo a full course of treatment. If a woman neglects treatment, the disease can cause a number of complications.

The most important danger of a cyst is the likelihood of malignancy. If the tumor in the ovary becomes cancerous, it will have to be removed surgically. In order to prevent malignancy of the formation, the patient must regularly visit the gynecologist. Modern diagnostic methods (laparoscopy and transvaginal ultrasound) make it possible to identify a malignant process at the first stage of its occurrence. With optimal treatment, serious consequences can be avoided.

Another complication is torsion of the tumor stalk. This phenomenon is accompanied by signs of appendicitis, so a woman may confuse torsion with appendicitis.

If the blood circulation in the cyst is disrupted, the patient may develop peritonitis or tissue necrosis. This complication manifests itself in the form of fever and nausea. The process of obstructed blood circulation can only be normalized surgically. During the operation, a woman's ovary is completely removed, and in some cases the tubes are also removed.

Twisting of the pedicle of the formation leads to intestinal obstruction. Because of this, pus or internal bleeding may appear in the tumor. If we talk about cyst rupture, then most often such a complication arises from an endometrioid type formation.

Important! Important! Any violation is corrected surgically. If measures are not taken in time, a woman may become infertile.

If the operation was performed on time, it does not injure the ovarian follicles. Thus, serious consequences most often occur after emergency surgery. Many doctors adhere to a wait-and-see approach when a cyst appears. But this only applies to small and harmless formations that can go away on their own. And such tumors are very difficult to detect during diagnosis. Thus, a cyst that is palpable or visible during ultrasound should be treated urgently. Many women themselves create a threat to their health when they refuse to treat the disease and prefer to wait. But this position only creates difficulties during treatment and entails a complex surgical operation.

Often women leave the ultrasound room with a note about the presence of a liquid formation in the ovaries, but they do not understand what it is. Health is no joke, a visit to the gynecologist is highly desirable, but you want to know the details! We will try to explain what this means, how it affects the body and whether something needs to be done.

What are the types of fluid formations in the ovaries?

There is quite a wide variety of such volumetric formations. This is a kind of bubble filled either with one liquid of varying degrees of viscosity, or with a liquid with dense inclusions. In structure it can be one-, two- or multi-chamber. Sizes can vary from small to gigantic. Below we will consider all the known variants of mucous and watery formations.

Follicular ovarian cyst

Due to irregular atresia of a normal follicle after ovulation. Instead of resorption, fluid begins to accumulate in its cavity, and this condition can last up to 8-16 weeks. The size of such a cyst can vary between 2 and 12 cm. Most often, especially with small sizes, they can resolve within 2-3 menstrual cycles. Sometimes surgery is required if the cyst has not disappeared within 4 months.

On ultrasound, a follicular cyst appears as a round or oval thin-walled formation located on the side or behind the uterus. Its structure is homogeneous, anechoic (liquid), single-chamber, without blood flow.

Corpus luteum cyst

When a normally functioning corpus luteum does not dissolve after menstruation, but is filled with liquid contents and remains to exist for at least one cycle. Its dimensions do not exceed 8 cm (starting from 2 cm), in most cases (more than 85%) it resolves on its own.

Ultrasound reveals either a homogeneous formation without echogenicity, or the same liquid formation, but with denser inclusions or a mesh structure.

Theca luteal cyst

With hydatidiform mole or choriocarcinoma, excess production of luteinizing hormone and human chorionic gonadotropin occurs. As a result, there is an excessive proliferation of theca cells of the ovarian follicle, which is why a cyst appears. Most often, it appears simultaneously in both the right and left ovaries, reaching in some cases a 30-centimeter diameter. After the elimination of a hydatidiform mole or choriocarcinoma, this type of cyst usually disappears after 1-3 months.

On ultrasound, this is a multi-chamber formation filled with anechoic homogeneous content.

Paraovarian cyst

Size 3-15 cm, with a relatively thick wall, with watery contents. Often it contains a suspension of varying degrees of echogenicity, which moves when the abdomen is tapped in the area where the cyst is located. It is located directly next to the ovary, often completely hiding it from view. These cysts, unlike those described earlier, are not able to regress (resolve).

Serosocele

This is not a cystic formation, but it is very similar to it. It usually occurs as a result of surgical intervention on the pelvic organs (usually due to severe forms of salpingo-oophoritis with pelvioperitonitis) or widespread endometriosis.

Ultrasound reveals an irregularly shaped formation in the pelvis, which has no walls, changes its shape (detected by repeated ultrasound examination), and contains free fluid.

Dermoid cyst

Originating from embryonic tissue cells. Often, in addition to liquid contents, cells or even parts of organs (sometimes entire organs) are found in them - skin, fat, teeth, hair, nervous bone, muscle tissue, glandular epithelium, etc. Up to 60% of such cysts are asymptomatic and are detected accidentally.

On ultrasound, such cysts look like a round or oval tumor in several echo variants:

• Anechoic structure with a small dense inclusion on the inner surface.
• The structure is the same, but there are many dashed or linear inclusions.
• Areas of anoechogenicity move with areas of high density. This is the most common form of cyst.
• A complex structure with a combination of areas of different densities, with partitions, suspension, and streak inclusions.

Serous cystadenoma

Single-chamber, smooth-walled. The contents are serous fluid (this becomes clear after removal of the formation). Sometimes particles of a dense structure can be detected in its composition, and this means a high risk of its malignancy.

Ultrasound reveals a round tumor, the size of which varies greatly from 4 mm to 32 cm. It is localized above or behind and to the side of the uterus (depending on its size). Its contents are anechoic, but in a third of cases there are denser inclusions - calcifications.

Papillary cystadenoma

It differs from the serous form by the presence of growths from the inner wall of the tumor. The ultrasound picture corresponds to the previous form; at the same time, multiple growths of the spongy structure are visible.

Mucinous cystadenoma

It looks like a large one-sided multi-chamber formation with a smooth wall.

Ultrasound shows a round formation located on the side and posterior to the uterus, the size varies from centimeters to tens of centimeters (a case of removal of a 14-kilogram cystadenoma is described). The tumors exhibit septa that form structures similar to a honeycomb. Their contents are liquid with a large amount of fine suspension - mucin.

Symptoms of fluid formations

Very often, cystic formations in the ovaries are asymptomatic for many years. They are discovered accidentally during examination for other gynecological diseases.

Pain is characteristic either with the development of complications, such as, or infection. Such pain is usually sharp, occurs suddenly and is accompanied by signs of bleeding or intoxication. Chronic pain is also possible, appearing when the cyst is large and compresses neighboring organs.

In the latter case, symptoms associated with the effect on the gastrointestinal tract and urinary system may appear - urinary retention, constipation. Also, due to compression of the pelvic vessels, varicose veins, hemorrhoids, and swelling of the legs may develop.

Treatment of cysts

Patients are treated conservatively:

• with unilateral fluid cysts without inclusions,
• premenopausal and menopausal women with small single formations;
• with a normal level of CA-125 (a marker of a malignant process);
• in the absence of symptoms of compression, bleeding, infection.

Surgical treatment is absolutely indicated for the development of complications - torsion of the cyst stalk, its rupture. In this case, severe pain and signs of large blood loss are noted.

Removal of the cyst is also indicated if any symptoms of trouble appear that occur when it compresses neighboring organs and blood vessels. In this case, the operation is performed as planned, having previously prepared the patient’s body for the intervention.

The operation is usually performed laparoscopically. In some cases (for example, when a malignant process is detected), the doctor may proceed to open surgery.

With a benign course of the cyst and elimination of provoking factors - hormone imbalance, treatment of hydatidiform mole, etc. – there are usually no relapses and the prognosis is favorable. If the late postoperative period is incorrectly managed, clinical follow-up is refused, as well as if atypical cells are detected in a distant formation, the prognosis of the disease worsens.

Fluid formation in the ovary only indicates that there is something in the pelvis that should not be there. It's not necessarily cancer, but it is a disease that requires attention. Contact your gynecologist and follow his recommendations.

Hello. My sister was diagnosed with fluid between her uterus and ovary. It was written about a rounded formation. What could it be? Antonina, 34 years old

Good afternoon, Antonina. The above describes many different formations that can be found in women of reproductive age. Without a clear description of the results of an ultrasound study, it is difficult to judge what type of process was identified. Let your sister contact a gynecologist; in any case, it is the doctor who is obliged to make an accurate diagnosis and prescribe treatment appropriate to the situation.

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