What are the complications of the cyst? Well, first and foremost if any cyst, any of these types of cysts we talked about; the benign ones can cause a problem if they get so large that they start twisting, called torsion. And, when an ovary generally gets bigger than 10 centimeters that can be a problem. New York OB/GYN Christopher Freville reports to have seen it less than that, but when the ovary starts twisting itself just imagine a tube with a big ball on the end and by movement or whatever this tube gets twisted and twisted. You ultimately end up shutting down the blood supply and causing that particular ovary tube, called the addnexit to loose it’s blood supply, become necrotic, which means tissue dies, and it has to be removed. Well, prior to that process it’s extremely painful. Most of the time those torsed ovaries cannot be saved. Which is not a problem because just like kidneys, just like testis, women with one ovary can have just as many babies as a woman with two ovaries and two tubes. So it doesn’t decrease the fertility by half which is a common misconception.

So we’ve got torsion as a complication. Obviously the pain is a definite complication and if the pain persists, well it’s time to have something done. The complications of endometriomas of course, and polycysticomas; the most common ones are infertility. The endometriomas, if they persist, and there’s continuous bleeding in the abdomen and the ovary that can cause adhesions. Any bleeding cyst can be a problem. Any cyst can have a blood supply. Most of these, the bigger blood supplies, the bigger blood vessels on cysts are usually the corpus luteum cyst. A pregnancy with a corpus luteum, the second type of functional cyst goes on to develop as the baby is growing. The blood supply is very, very rich and they break, they burst, they rupture a vessel can pump blood into the abdomen and can be a life threatening condition. The same thing can be true with, certainly with tube pregnancies, that’s why those two can be confused. So, you can have bleeding with a cyst but most of the time those are rare circumstances. Torsion, bleeding, when it ruptures most of the time there’s going to be pain.

Can a cyst become cancer? Now, here’s the big question.

That’s again the cancer fear that all women have. The answer, I’d say is no. This has been looked at pretty, pretty extensively. There was a rather large study I think it was in Sweden. They looked at something like 90,000 - they’ve got a very sophisticated system of registry in Sweden where they can look at data. And something like ninety thousand women were paired with 90,000 normal ones and the various kinds of cysts, endometriomas, the functional cyst, the non-functional cyst. And they said “Well what’s the likelihood any of these women come back for ovary cancer”? And there was no difference. If you had an ovary cyst that was benign you had no increased incidence of having cancer later. The only difference in this was endometrioma which had a slight increase difference. And possibly the reason for that is something to do with estrogen sensitivity around the ovary. But again it’s, it was somewhat more common but it’s nothing to say “My gosh, I’ve got endometrioma, by now I’ve got to have cancer”. That should be the farthest thing from a persons mind. So I’d say without question – The fact that one has a cyst it is not going to develop to, you do not have an increased cancer risk. Now certainly the cystadinomas it’s felt that some of these, these are the benign tumors. Can these cystadanomas develop into cystoadnocarsonoma? The answer is, yes probably. But, once you’ve removed it, the cystadinoma, as well as removing the dermoid cyst, which are very rarely cancer you’ve eliminated that risk. If a woman is going to have a cancerous cyst it’s going to be there from a cancerous cyst per say. She most likely is over the age of fifty and their, in general the reproductive years do not have, a woman does not have to be concerned that a cyst is going to transgress, develop into a cancer.