Mucinous Ovarian Cysts

Introduction

• Description: A group of benign and malignant epithelial tumors of the ovary that are characterized by mucin secretion. These tumors tend to be the largest types of ovarian masses encountered and may be 30 cm or greater in size.

• Prevalence: 15%–25% of ovarian cysts and 6%–10% of ovarian cancers. Although ovarian cysts are common in younger women, mucinous cysts account for approximately 50% of those that occur in women older than 20 years.

• Predominant Age: Reproductive age (benign); 30–60 years (malignant tumors).

• Genetics: No genetic pattern, although mutations of the BRCA1 and BRCA2 genes impart a 2- to 3-fold increase in risk. Other genes have been implicated but represent a small number of cases.

Etiology and Pathogenesis

• Causes: Unknown. May represent a monomorphic endodermal differentiation of a teratoma or a tumor of Müllerian origin.

• Risk Factors: Family history, high-fat diet, advanced age, endometriosis, nulliparity, early menarche and late menopause, White race, higher economic status. Oral contraception, high parity, and breastfeeding reduce the risk.

Signs and Symptoms

• Asymptomatic

• Vague lower abdominal symptoms

• Adnexal mass (bilateral in 5% of benign and 10%–20% of malignant lesions) up to 50 cm in diameter (average, 15–30 cm)

• Pleural effusion and shortness of breath

Diagnostic Approach