The Difference Between a Simple Ovarian Cyst and a Complex Ovarian Cyst

Cancer, Symptoms and Diagnosis

It’s not common, but ovarian cysts can be malignant. Most ovarian cysts are benign, especially those that develop before menopause. Ovarian cysts are quite common in women who ovulate. You’re less likely to develop cysts after menopause. Cancerous cysts develop when mutated ovarian cells begin to grow and reproduce. If you develop an ovarian cyst after menopause, it increases your risk for ovarian cancer.

There are two main types of ovarian cysts: ovarian cysts can be simple or complex. Simple ovarian cysts don’t typically lead to cancer or an increased risk of it and many simple ovarian cysts will disappear on their own. The International Tumour Analysis Group (IOTA) has standardized definitions for adnexal lesions.

Simple Ovarian Cyst

A fluid-filled ovarian cyst is a simple cyst (also known as functional cysts). Simple cysts are common because they form due to a woman’s normal menstrual cycle. Women who ovulate are most at risk for developing an ovarian cyst. Simple cysts usually have no symptoms.

Complex Ovarian Cyst

Ovarian cancer is more likely in women who have a cost that appears complex. A complex ovarian cyst contains solid material or blood. Complex cysts aren’t related to a woman’s normal menstrual cycle and they’re less common. After menopause, ovarian cysts are more likely to develop into ovarian cancer. A large size (greater than 5 centimeters to 10 centimeters) does not predict whether a cyst is cancerous.

A complex ovarian cyst may be benign, but is more likely to be cancerous if it contains nodules or excrescences (abnormal growths). An ovarian cyst with a septum is medically evaluated as a dangerous form of cyst. Ovarian cysts that contain papillary structures, solid areas and increased vascularity are more likely to be malignant.

Complex ovarian cysts, such as dermoids or cystadenomas, can grow too large. This can push your ovary out of place. It can also cause a painful condition called ovarian torsion, which means your ovary has become twisted.

Complex ovarian cysts may need further treatment. 5 to 10 percent of women need surgery to remove an ovarian cyst and 13 to 21 percent of these cysts turn out to be cancerous. If there is a suspicious of cancer, the whole ovary must be removed.

The Best Imaging Test to Characterize Ovarian Cysts

Ovarian cysts can often be distinguished from solid masses or complex cysts on ultrasound. Ultrasound imaging can help determine the location, size and shape of a cyst. It may also be able to tell if the ovarian cyst is simple or complex.

Transvaginal ultrasound involves the insertion of a wand-like device into the vagina. It can image tissues using sound waves. This is the single most effective way of imaging and characterizing ovarian cysts. A definitive diagnosis is achieved through surgery.

Screening for Ovarian Cancer

Ovarian cancer often has no symptoms in the early stages and can only be detected by gynecological exam and ultrasound. A routine pelvic examination performed by your physician may detect a mass in the region of your ovary, referred to as an adnexal mass.

CA-125 is a blood test that measures the level of a protein called CA-125. It is secreted by ovarian cancer cells and is useful in supporting a cancer diagnosis in high-risk women. CA-125 is elevated in a large percentage of epithelial ovarian tumors, and a very high result (such as CA-125 over 1,000) increases the likelihood of an ovarian cancer diagnosis. The level of CA-125 at the time of diagnosis may also help predict the prognosis.

Risk Factors for Ovarian Cancer

Endometriosis, a condition in which tissue similar to uterine (endometrial) tissue grows outside of the uterus, is linked with a greater risk of ovarian cancer. If you are BRAC positive, your risk of ovarian cancer is significantly higher than someone without the mutation. The use of feminine sprays and powders containing talc have been linked to ovarian cancer.

Treatment Options and Prognosis for Ovarian Cancer

If you have ovarian cancer, your outlook depends on how far the cancer has spread. The outlook is best when the doctor diagnoses and treats ovarian cancer in the early stages. Treatment options include surgical removal of the ovary, chemotherapy and radiation.

According to the American Cancer Society, the 5-year survival rates for women with epithelial ovarian cancer (the most common kind) that has spread beyond the original site:

  • Localized:     93%
  • Regional:      75%
  • Distant:         31%

Most women diagnosed with ovarian cancer will have some form of surgery to remove the tumor. Many women with ovarian cancer will undergo hysterectomy with bilateral salpingo-oophorectomy. This means the uterus, both ovaries and both fallopian tubes are removed.