Ovarian Masses: Cysts and Tumors


Ovarian masses are growths on or in the ovaries – the small reproductive organs located on each side of a girl’s uterus that store and release eggs and produces female hormones.

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

According to the NIH, each month during a menstrual cycle, a follicle grows on the ovary.  A follicle is where an egg is developing. Most months, an egg is released from this follicle. This is called ovulation. If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst. This is called a follicular cyst.

Another type of cyst occurs after an egg has been released from a follicle. This is called a corpus luteum cyst. Such cysts often contain a small amount of blood.

Ovarian cysts are more common from puberty to menopause. This period of time is known as the childbearing years. Ovarian cysts are less common after menopause.

Taking fertility drugs can cause a condition in which multiple large cysts are formed on the ovaries. This is called ovarian hyperstimulation syndrome. The cysts usually go away after a woman's period, or after a pregnancy.

Functional ovarian cysts are not the same as ovarian tumors (including ovarian cancer) or cysts due to hormone-related conditions such as polycystic ovary syndrome.

Symptoms & Types

Ovarian masses include:

Symptoms of ovarian cysts and tumors may include:

  • Abdominal pain or tenderness
  • Bloating
  • Dull backache
  • Increase in abdomen size
  • Nausea or vomiting
  • Abnormal menstrual bleeding
  • Painful periods
  • Difficulty urinating
  • Pain during intercourse or bowel movements
  • Pressure on the rectum or bladder
  • Difficulty emptying the bladder completely

In some cases there may be no symptoms at all.

  • Cysts – Cysts are fluid-filled sacs or pouches that form on or inside a girl's ovary. Ovarian cysts are common in young girls. In most cases they are benign (not cancerous) and will disappear on their own without treatment. While the exact cause is unknown, they tend to form when the ovaries produce too much of the hormone estrogen. They can sometimes be associated with precocious puberty, a condition in which the body begins to go through puberty too early. In some cases, the cyst may cause the ovary to twist, blocking blood supply and causing severe pain, bleeding and other symptoms.
  • Tumors – Tumors that form in the ovaries are less common than cysts. They can be either cancerous (malignant) or noncancerous (benign). Four out of five ovarian tumors in girls under age 8 are benign. The exact cause of ovarian tumors is unknown; however, inherited defects, chromosome abnormalities and genetics may be contributing factors.

Diagnosis & Tests

Diagnosis starts with a detailed medical history and thorough physical exam, including an abdominal and pelvic exam.

Often ovarian masses in children and young girls are found during routine exams when the doctor discovers a lump or mass.

Additional tests may include:

  • Blood tests – to check hormone levels
  • Ultrasound or other imaging tests – to create images of the uterus and ovaries to determine the size and location of cysts and tumors
  • Laparoscopy – a thin tube with a camera on the end (laparoscope) is inserted through a small incision in the abdomen to view the ovaries
  • Biopsy – removal of a small tissue sample for examination under a microscope

Treatment & Care

Treatment depends on the individual, the type of mass, its cause and symptoms.

Treatment strategies include:

  • Close observation – for ovarian cysts with no symptoms that are likely to go away on their own without treatment
  • Pain medication
  • Birth control pills – to prevent ovulation, reducing the likelihood of new cysts developing
  • Surgery – to remove a mass
  • Radiation or chemotherapy if the mass is cancerous
  • References & Sources