Ovarian cysts – What are they ?

I have been told I have an ovarian cyst, what is it?

  • Ovarian cysts – a fluid-filled sac 
  • Very common –the majority are asymptomatic 
  • Usually detected on routine USG
  • 1 in 10 requires intervention 10 


Risk factors

  • No definitive factors
  • Hormonal imbalance
  • Genetic factors - BRCA gene





  • Bloating
  • Pelvic / abdominal pain
  • Early satiety
  • Urinary symptoms
  • Menstrual disturbances.


What tests are done?

  • Ultrasound
  • CT /MRI scan if doubtful
  • Blood tests – CA 125, HCG, AFP, LDH
  • FNAC / biopsy is not to be done FNAC


Types of ovarian cyst

Benign ovarian tumor


  • Dermoid cyst
  • Chocolate cyst/ endometriotic
  • Cystadenomas
  • Fibromas
Ovarian cancer


  • Epithelial – most common
  • Germ cell tumor
  • Sex cord-stromal tumor


  • Not all ovarian cysts are cancerous, the majority are benign.
  • Diagnosis depends on scanning report – complex cysts, solid component.
  • Blood tests – CA 125, HCG, AFP, LDH.


Do all ovarian cysts require surgery?

  • Cysts that are benign on imaging and blood tests.
  • Small cysts - close monitoring
  • Surgery
    1. if the size is increasing
    2. Causing symptoms due to torsion/infection/hemorrhage
    3. Large cysts >6cm
    4. Simple cysts with no symptoms - further imaging and assessment
    5. Surgery – if any doubts about cancer/symptoms/complex cyst


What is the surgery for a benign ovarian cyst?

  • Surgical removal of the cyst.
  • Surgery - open/keyhole
  • Keyhole surgery is to be avoided if there is any doubt of cancer in the cyst.


Do all ovarian cysts become cancer?

  • The cyst is either cancerous or benign from the beginning.
  • The chance of a benign cyst going to become cancer is very minimal.
  • Surgery is not to be done just because a cyst is present.


In a nutshell

  • The majority of ovarian cysts are benign and require no intervention.
  • The Nature of cysts is determined by scans and blood tests.
  • When indicated surgery is the only treatment option.