A bulging stomach not only gave her a pregnancy look but hampered her everyday activities. The heavy tummy turned worrisome when she started gaining weight, and the parents of the 19-year-old Bangalore woman approached the doctors. She was diagnosed with an unusual growth of an ovarian cyst. The ovarian mass was found to be benign and ruled out the risks of ovarian cancer.
An ovarian mass is an abnormal cell growth in the ovaries that could be malignant (cancerous) or benign (non-cancerous).
The woman underwent surgery for laparoscopic removal of the ovarian mass in March 2024. She was operated on by Dr Chaitra S Niranthara, chief obstetrician and gynecologist at Cans Multi Specialty Hospital, Bangalore. “Her stretch marks resembled that of pregnancy,” Dr Niranthara recalled. Although parents claimed that the abdomen distention was from the past six months, Dr Niranthara says such ovarian masses take at least 2-3 years to grow to that size.
Having dealt with similar cases, Dr Kiran Coelho, head of the department and consultant obstetrics gynecology at Lilavati Hospital And Research Center, Mumbai, says it can affect any woman of reproductive age.
In the year 2023, Dr Coelho surgically removed another benign ovarian mass from a 44-year-old woman in Mumbai. She visited the doctor when her mobility was almost suspended due to an enormous tumor in her abdomen. “The ovarian tumor weighed 20kgs and was a mucinous cystadenoma, a benign cyst on the epithelium layer of the uterus. The case was documented as the first largest mass removed through laparoscopy globally,” Dr Coelho told Happiest Health.
Symptoms of ovarian mass
The symptoms of abnormal growth in the ovaries or ovarian mass, as Dr Niranthara explains:
- Abdominal pain
- Loss of appetite
- Menstrual irregularities or cramps
- Intermenstrual bleeding
- Significant weight changes
- White discharge
- Stretch marks
However, the symptoms can differ from one case to another. Interestingly, the 19-year-old woman continued to have her menstrual periods, and there was no suspicion of problems in the uterus. “The woman also had no loss of appetite,” says Dr Niranthara.
Dr Coelho adds that the feeling of fullness in the stomach and a bloating sensation all the time are the other symptoms. In rare cases, this mass can become cancerous. The symptoms for cancerous tumors also include — gaseous distension, indigestion issues, and repeated burping, adds Dr Niranthara.
Types of ovarian mass
Tumors can grow in and around the ovaries. “Epithelial tumors grow on the surface of the epithelium, whereas germ cell tumors grow in the egg or follicle cells of the ovaries. Stromal ovarian tumors grow in the connective tissues that hold the ovaries together,” explains Dr Coelho. “Among these, the most common are epithelial tumors such as serous cystadenoma and mucinous cystadenoma. These are mostly benign cystic epithelial tumors that are asymptomatic — thus delayed detection,” explains Dr Coelho.
Dr Niranthara clarifies that ovarian cysts are not the same as polycystic ovaries. Multiple small cysts in the ovaries are caused by hormonal changes, which can cause polycystic ovarian syndrome (PCOS).
Risk factors
Younger women who are at their reproductive age and women as old as 65 years are at risk of developing ovarian mass. The risk increases after 40 years of age, adds Dr Coelho. “Delayed childbearing, diabetes, use of oral contraceptive for 10 or more years, extensive duration of fertility treatment, and family history of ovarian cancers are the risk factors, she explains. “Also, consanguineous marriages and obesity are other risk factors of ovarian mass in women,” adds Dr Niranthara.
Treatments for ovarian mass
Benign ovarian masses are removed through laparoscopy, a surgical procedure of the pelvis or abdomen using a thin, lighted tube with a video camera inserted through a small incision.
“For malignant tumors, doctors recommend open surgery to avoid spillage of the cancerous cells in the abdominal cavity,” describes Dr Coelho.
Ovarian tumors can be prevented
Every sexually active woman must get annual clinical examinations and pelvic sonography, advises Dr Coelho. “Sonography helps examine the ovaries in detail. One can identify the presence of polycystic ovaries, epithelial or any other form of cysts or tumors,” she adds. Further, if abnormal cysts exists, tumor biomarker tests are advised (such as serum CA125, CA199 and CEA) to check for malignancy, she explains.
Other tests that women must do include a pap smear (once every three years), hemoglobin test (to check for anemia), thyroid test (to check thyroid disorders), ultrasound scans, and HbA1c (to check diabetes), adds Dr Niranthara.
“Those with a family history of ovarian cancer must get a BRCA gene test, which will examine the changes in the BRCA1 and BRCA2 genes and indicate the risk of breast and other cancers,” cautions Dr Niranthara.
Takeaways
- Ovarian masses are abnormal cell growth in the ovaries that could be malignant or benign.
- All women who have attained puberty until the end of their lives are at risk of developing ovarian mass.
- Experts insist on early identification through annual examinations and pelvic sonography to avoid the growth of these tumors into cancer.
