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What is an ovarian cyst?

Ovarian cysts are fluid-filled sacs that usually dissolve after ovulation and can cause pain, but most often go away on their own. Benign ovarian cysts, that do not regress spontaneously, may be cured by surgically removing or draining them, but new cysts may form in the future. They can affect infants, young girls, and adolescents. These cysts can appear on one or both ovaries, individually, or in clusters. Complications of cysts can include disruption of the blood flow to an ovary (torsion) or rupture.

Cysts are almost always benign but can develop into cancer. Ovarian tumors account for 1 percent of all malignant tumors found in children from birth to the time she's 17. In girls younger than 8, four out of five ovarian tumors are benign (non-cancerous).

What are the types of ovarian cysts?

There are several types of ovarian cysts, including:

  • Functional cysts (follicular cyst or corpus luteum cyst)
  • Polycystic ovaries
  • Endometriomas
  • Cystadenomas
  • Dermoid cysts

Symptoms & Causes

What are the symptoms of ovarian cysts?

Ovarian cysts may have no specific symptoms. Depend on the size, location and type of growth, your child may experience the following symptoms:

  • Feeling of pressure or fullness in the abdomen or pelvis
  • Firm, painless swelling in the lower abdomen
  • Frequent urination or retention of urine
  • Persistent abdominal pain
  • Nausea
  • Vomiting

Sometimes, ovarian cysts cause the ovary to twist and block blood flow from the ovary. In this situation, your child will likely experience severe abdominal pain and may vomit or pass out.

In children younger than 8, an ovarian cyst may cause secretions of estrogen, producing symptoms such as:

  • Breast enlargement
  • Pubic hair
  • Vaginal discharge or bleeding
  • Abnormal menstrual bleeding

What is the cause of ovarian cysts?

In adolescence, ovarian cysts can develop in response to fluctuating levels of female sex hormones during the menstrual cycle.

Diagnosis & Treatments

How are ovarian cysts diagnosed?

The first step in treating your daughter is forming an accurate and complete diagnosis. Because most ovarian cysts don’t cause symptoms and go away on their own, they may go completely unnoticed. If your child has pain or irregular periods, her doctor may recommend several tests which may include one or more of the following tests:

  • Pelvic ultrasound: This imaging procedure uses sound waves to make a picture of your child's ovaries, uterus and bladder. A full bladder may be necessary for the test. If the ultrasound detects a cyst, your child's doctor will likely repeat the ultrasound in two to eight weeks to make sure it is shrinking. If the ultrasound shows a cyst filled with clear fluid it is unlikely a tumor; if it shows debris in the cyst fluid or solid parts, your child's doctor will likely recommend further testing.
  • Pregnancy test: In pregnancy, harmless cysts often form when the ruptured follicle releases the egg, reseals itself and fills with fluid.
  • Biopsy: The mass is removed with great care not to spill the contents of the mass if there is a concern for malignancy.
  • Urine and blood tests
  • CT scan

How are ovarian cysts treated?

Your child's physician will determine a specific course of treatment based on several factors, including your child's age, overall health, and medical history. If your daughter has been diagnosed with an ovarian cyst, her treatment may include:

  • Watchful waiting: Most ovarian cysts go away without any treatment.
  • Draining: If your daughter has a cyst bigger than two inches across, it may need to be drained with a needle to keep it from twisting and pinching off the ovary's blood supply.
  • Removal: Sometimes an ovarian cyst may not go away and needs to be removed. In this case, a surgeon would remove the cyst while leaving the rest of the ovary in place.

How we care for ovarian cysts

If your child has an ovarian mass, they will be treated by the Division of Gynecology at Boston Children's Hospital. We have been caring for infants, children, and adolescents for more than three decades, and we are experts in the diagnosis and treatment of ovarian cysts.

Practitioners Who Specialize In This Condition (3)

Frances Grimstad MD, MS

Frances Grimstad, MD, MS

Pediatric & Adolescent Gynecologist, Division of Gynecology
Associate Professor of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School
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