Adolescent Ovarian Cysts

Adolescent Ovarian Cysts

An ovarian cyst is a fluid-filled sac that forms on an ovary (where ova or eggs are produced). It is important to know that the ovaries are “cystic structures.” Normal ovaries have lots of small cysts in them, and this is the sign of a “healthy ovary.”

What are Adolescent Ovarian Cysts?

Ovarian cysts commonly occur in females of all ages. Some fluid-filled sacs develop during the normal menstrual cycle (period). Cysts often go undiagnosed or will dissolve on their own. The cysts are typically small (approximately 2 to 20 mm), but they can grow larger.

What are the different types of Adolescent Ovarian Cysts?

There are two main classes of ovarian cysts: functional (normal) and other. Some cysts are not related to the menstrual cycle.

Functional Cysts

Functional cysts are part of the normal menstrual cycle. During the beginning of a typical menstrual cycle, fluid-filled pockets (follicles) grow on the ovary, and each contains an egg. All but one follicle stops growing, and the rest are absorbed back into the ovary. The remaining follicle produces estrogen and progesterone (primary female sex hormones), and it will release the egg during ovulation.

Each class of cysts has multiple types, including the following:

Functional Cyst Complications

  • Corpus luteum cyst – After ovulation, a cyst can form on an ovary kind of like a “bruise.” Most often this is asymptomatic, but it occasionally can cause some minor pain.

Other Cysts

  • Cystadenomas – The cysts will develop on the ovary’s surface and are filled with thin, watery fluid or a thick, mucous-like material. These are usually benign.
  • Dermoid cysts (teratomas) – The cysts form from embryonic cells and can contain hair, skin or teeth. These are usually benign but can become large (>4 cm), and they can torse or twist causing pain.
  • Endometriomas – The cysts develop due to endometriosis. Uterine endometrial cells grow outside the uterus, which can attach to the ovaries and form cysts.

What are the signs and symptoms of Adolescent Ovarian Cysts?

Symptoms of functional cysts are rarely noticed, and they often disappear on their own within two or three menstrual cycles. If a cystadenoma or a dermoid cyst becomes large (over 4-5 cm), it can move the position of the ovary.

Possible Complications

Complications may occur in some cases and can include the following:

  • Ovary rupture – Large cysts (larger than 4-5 cm) may cause the ovary to leak, which can lead to hemorrhaging and pain.
  • Hemorrhage – Internal bleeding may occur if the cyst ruptures.
  • Torsion (twist) – Cysts can move the ovary, causing it to twist on its pedicle or blood supply. Torsion causes severe pain, nausea and vomiting. It can also lead to a decrease or stoppage of blood flow to the ovary, and the need for emergency surgery.

What are the causes of Adolescent Ovarian Cysts?

Most ovarian cysts develop as a result of the menstrual cycle.

Risk Factors

  • Endometriosis  – Uterine endometrial cells grow outside the uterus, which can attach surrounding tissues and ovaries and form cysts.
  • History of ovarian cysts – While it is not always the case, girls are more likely to develop ovarian cysts if there is a history of other cysts.
  • Pelvic infection – Cysts can develop if a severe infection spreads to the fallopian tubes and ovaries.

How are Adolescent Ovarian Cysts treated?

Small cysts can be observed; larger ones require removal.  Sometimes the cyst enlarges to an abnormal size and may require excision.  Often, this can be done with a minimally invasive (laparoscopic) approach that saves the associated ovary.  If the cyst is very large, an open operation may be required to remove it. 

Ovarian tumors in children are most often benign but can be malignant.  Excision of ovarian tumors is required, saving the ovary, if possible in benign tumors. 

Ovarian tumors and cysts occasionally cause twisting of the ovary and fallopian tube.  In these cases, they are found when a patient is evaluated for abdominal pain.  Twisted ovaries require prompt surgery to prevent damage to the ovary from lack of circulation.

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