Ovarian Tumors

Overview

An ovarian tumor is an abnormal growth that develops in or on one of the ovaries, the two small organs that produce eggs and hormones. The term covers a wide range of growths. Many are benign (non-cancerous), such as simple cysts and common benign tumors. Some are borderline, meaning they have unusual cells but rarely spread. A smaller number are malignant (ovarian cancer).

Ovarian tumors are common, and the great majority are not cancer, especially in younger women. However, because ovarian cancer can cause vague symptoms and is often found late, any persistent ovarian mass deserves proper evaluation.

Symptoms

Small ovarian tumors often cause no symptoms and are found by chance during a scan or exam. When symptoms occur, they are frequently vague and easy to mistake for digestive or bladder issues:

• Persistent bloating or a swollen abdomen
• Pelvic or lower abdominal pressure, discomfort, or pain
• Feeling full quickly when eating or loss of appetite
• Needing to urinate urgently or more often
• Changes in periods or bleeding after menopause

Sudden, severe pelvic pain can signal a complication such as the ovary twisting (torsion) or a cyst rupturing, which needs urgent medical attention. Symptoms that are new, persistent, and occur most days for several weeks should be checked.

Causes

Ovarian tumors arise from the different cell types that make up the ovary, and the cause depends on the type:

• Functional cysts form during the normal menstrual cycle and are not true tumors; they usually resolve on their own.
• Epithelial tumors develop from the surface cells of the ovary and include the most common benign and malignant types.
• Germ cell tumors arise from egg-forming cells and are more common in younger women; most are benign (such as dermoid cysts).
• Stromal tumors grow from the hormone-producing tissue and may affect hormone levels.

The exact reason a tumor forms is often unknown, but inherited gene changes and hormonal factors play a role in some cancers.

Risk Factors

• Family history of ovarian, breast, or related cancers
• Inherited gene changes such as BRCA1 or BRCA2
• Older age, particularly after menopause, for ovarian cancer
• Never having been pregnant
• Early first period or late menopause
• Endometriosis, for certain tumor types

Diagnosis

Evaluation aims to find the mass, judge whether it is likely benign or worrisome, and guide treatment:

• Pelvic examination: May detect a mass or tenderness.
• Ultrasound: The main imaging test, usually transvaginal, to see the size and features of the mass.
• Blood tests: Markers such as CA-125 may be measured, interpreted alongside age and imaging, since they can be raised for non-cancer reasons.
• CT or MRI: Used to assess larger or suspicious masses.
• Surgery and biopsy: A definite diagnosis of the tumor type usually requires removing the mass and examining the tissue.

Treatment

Treatment depends on the woman's age, whether the mass looks benign or suspicious, symptoms, and the wish to preserve fertility.

• Watchful waiting: Many simple cysts and small benign-appearing masses are monitored with repeat scans and resolve without intervention.
• Surgery: A mass that is large, growing, causing symptoms, or suspicious is removed. The cyst alone may be taken out, or the whole ovary, depending on the situation.
• Cancer treatment: If a tumor is malignant, treatment is led by a gynecologic oncologist and may combine surgery with chemotherapy and other targeted therapies.

For benign tumors, removal is usually curative. For borderline tumors, surgery is the main treatment and the outlook is generally favorable.

Prevention

• Attend recommended gynecologic check-ups and report persistent symptoms
• Discuss family history of cancer with your doctor, who may suggest genetic counseling
• Know that long-term combined hormonal contraception is associated with a lower risk of ovarian cancer
• Seek prompt evaluation for new, persistent bloating or pelvic discomfort

When to See a Doctor

See a doctor if you have bloating, pelvic pressure, feeling full quickly, or urinary changes that are new and persist most days for two or more weeks, or if you have unexplained vaginal bleeding, especially after menopause.

Seek emergency care for sudden, severe pelvic or abdominal pain, particularly with nausea, vomiting, or fever, which can indicate ovarian torsion or a ruptured cyst.

Related Topics

Frequently Asked Questions

References

1. Mayo Clinic. Ovarian cysts and tumors — Symptoms and causes.
2. National Cancer Institute (NCI). Ovarian, Fallopian Tube, and Primary Peritoneal Cancer.
3. MedlinePlus, U.S. National Library of Medicine. Ovarian cancer and ovarian cysts.
4. American College of Obstetricians and Gynecologists (ACOG). Ovarian Cysts.