Serous Cystadenoma (Simple & Papillary)

What is Serous Cystadenoma?

Serous Cystadenoma is a cystic tumor in the ovary that contains a thin, transparent yellow colored serum and solid tissues. Although uncommon, it may appear in the pancreas and are known as a microcystic adenoma. Depending on the structure of the wall, the ovarian serous cystadenoma can be classified into two types:

  • Simple Serous Cystadenoma (flat & smooth surface)
  • Papillary Serous Cystadenoma (small dense growth resembling warts)

Simple Serous Cystadenoma

It has a smooth and flat surface, sold wall, fairly dense capsule and mostly affects only one ovary. Its size varies from 4-5 cm to 15 cm and affects women aging of 50 years or above.

Papillary Serous Cystadenoma

The papillary serous cystadenoma contains papillae in the inner surface and affects both the ovaries. They appear after a few years since the development of the simple serous cystadenom giving indications about developing into a disease. This tumor is of low malignant potential and does not cause cancer. It usually affects women aged between 40 to 60 years of age, although young children and infants are not affected.

Depending on the location of the papillae, the papillary cyst can be classified into the following forms:

  • Inverting: present in the middle of the cyst
  • Martiria: present on the outer surface of the capsule

Causes 

The origins are still unknown, but most of the scientists predict that it can be a cause of the hormonal imbalance in the body or the effect of myocardial inflammation (of the uterus).

Theory says that the serous cystadenoma gets formed due to the functional ovarian cyst and usually resolves on their own within a few months. In case it does not resolve, then some cells still remain and the ability of functional cyst after a year to naturally re-absorb get lost resulting in the formation of serous cystadenoma.

The papillary serous cystadenoma can be due to the genetic changes in the tumor, though its cause is not confirmed. But the specification of genetic changes is also seen in the rare purpose and its research is too limited.

Symptoms 

Simple Serous Cystadenoma

  • Nagging or discomfort pain in the abdomen
  • Lower back pain
  • Increase in the size of the belly
  • Feeling the presence of a foreign body
  • Frequent urination
  • Difficulty of defecation
  • Infertility issues

Papillary serous cystadenoma

  • Increase in the size of the abdomen due to accumulation of fluid
  • Abnormal menstrual bleeding
  • Weight loss
  • Bowel movement changes, such as constipation
  • Lack of appetizer
  • Nausea or vomiting
  • Feeling tired and lazy

Diagnosis

Serous cystadenoma is observed through ultrasound screening examination and it looks like a black rounded patch with clear counters. But sometimes the diagnosis does not give a fair result and often doctors get confused it to be a functional cyst.

Blood tests called sebum tumor should be done before the biopsy to confirm the appearance of ovarian These tests may include:

  • Human chorionic gonadotropin (HCG)
  • Lactate dehydrogenase (LDG)
  • CA-125 test
  • Estrogen levels
  • Testosterone levels
  • Inhibin (hormone)
  • Alpha-fetoprotein (AFP)

Tissue biopsy, a tissue biopsy of the tumor is performed and sent to the pathological center for examination

Exploratory laparoscopy uses a minimally invasive technique to examine the abdomen and this method can decrease the complications and the length of stay in the hospital.

Treatment 

It can be treated surgically, but in case of the independent ovarian cyst, it will never disappear. The operation depends on some underlying factors which include:

  • Condition of the ovary
  • Size, location, type of the cyst
  • Age of the patient
  • Possible side pathology

During treatment of uncomplicated serous cystadenoma, it is not justified as a malignant growth, if it does, it is a rare case. Although it is not cancerous, the treatment should be done as soon as possible to avoid massive complications.

In case of papillary serous cystadenoma, it causes great danger due to its various malignant degeneration. If the tumor is small, it does not require any treatment, but if the cyst is noticeable enough, then a surgical procedure with complete removal of the cyst is considered to be more efficient and is curative.

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