Ovarian cystic neoplasms are ovarian tumors that have cyst-like qualities. They can include epithelial ovarian tumors and germ cell tumors called teratomas. Ovarian cystic neoplasms can be benign, borderline, or malignant.

An ovarian cystic neoplasm isn’t the same as an ovarian cyst. Cysts and neoplasms are types of masses that can develop in the body, including on your ovaries.

Simply put, a cyst is a hollow sac that’s filled with a substance like fluid or air. A neoplasm is an abnormal (atypical) mass made when cells begin to grow and multiply out of control. Basically, it’s another word for a tumor.

Ovarian cystic neoplasms are ovarian tumors that have cyst-like qualities when viewed with imaging tests.

Several types of ovarian cystic neoplasms exist. According to a 2022 review of research, epithelial ovarian tumors and certain germ cell tumors are often considered cystic in nature.

Epithelial ovarian tumors form from the cells on the outer surface or layer of your ovaries. They include:

  • serous tumors
  • mucinous tumors
  • endometrioid tumors
  • clear cell tumors

Germ cell tumors form from the eggs that are stored in the ovaries and released during ovulation. A type of germ cell tumor called a teratoma is also considered cystic.

Ovarian cystic neoplasms can be benign, borderline, or malignant tumors. In general, an estimated 90% of ovarian tumors are benign.

Benign tumors are not cancerous. While they’re formed by an abnormal mass of cells, they do not invade or spread into other tissues. Examples of benign ovarian cystic neoplasms include:

  • serous cystadenomas
  • mucinous cystadenomas
  • mature teratomas

Malignant tumors are cancerous. These tumors can continue to grow in surrounding tissues and spread into more distant tissues. Examples of malignant ovarian cystic neoplasms are:

Borderline tumors fall into a bit of a gray area, as they appear more abnormal than benign tumors but also don’t clearly appear cancerous. You may also see these called low malignant potential (LMP) tumors. Examples include:

  • atypical proliferative serous carcinoma
  • atypical proliferative mucinous carcinoma

It’s possible to have an ovarian cystic neoplasm and have no symptoms (asymptomatic).

Asymptomatic ovarian cystic neoplasms are often found incidentally during imaging or surgery related to another medical condition.

When symptoms are present, they may include:

If you develop any of the symptoms above, it’s important to see a healthcare professional to discuss them. This is especially true if your symptoms are severe, persistent, or recurring.

If you have a malignant ovarian cystic neoplasm, your outlook is best when it’s diagnosed and treated early.

Experts do not yet know the exact cause of ovarian cystic neoplasms. On a basic level, tumors can develop when DNA changes lead to cells growing and dividing out of control. These DNA changes can happen due to several causes:

  • naturally occurring errors made when your cells divide
  • damage to DNA that happens due to environmental or lifestyle factors
  • DNA changes that are inherited from your parents

Benign tumors can sometimes grow to be quite large. However, they don’t grow into surrounding tissue or spread further in the body. Once removed, they often don’t come back.

However, sometimes cells also acquire changes that promote invasion into surrounding tissues and spread to more distant areas of the body, a process called metastasis. These tumors are malignant.

To diagnose an ovarian cystic neoplasm, a healthcare professional may start by requesting your medical history and doing a physical exam, which often includes a pelvic exam.

If an ovarian tumor is suspected, a healthcare professional may order additional tests to help confirm a diagnosis, including:

Treating ovarian cystic neoplasms

If you receive an ovarian cystic neoplasm diagnosis, the treatment plan can depend on many factors, including:

  • the specific type of tumor
  • whether the tumor is cancerous and if cancerous, what stage it is
  • how large the tumor is
  • your age and overall health
  • your personal preference

A doctor may opt for monitoring benign ovarian cystic neoplasms that are small and aren’t causing symptoms. They may want to periodically check on the tumor and initiate treatment only if it gets larger or starts causing symptoms.

Healthcare professionals may prefer to use removal surgery for a benign ovarian tumor that’s large, growing quickly, or causing significant symptoms.

If you plan on becoming pregnant and the ovarian cystic neoplasm is on the smaller side, it’s possible that only the tumor is removed, which helps to preserve fertility. However, sometimes doctors may consider it necessary to remove the entire ovary in a surgery known as oophorectomy.

Surgery is often the main treatment for malignant cystic ovarian neoplasms. This can involve the removal of the ovaries, fallopian tubes, uterus, and sometimes other tissues to get rid of as much of the cancer as possible.

Other potential treatments for malignant cystic ovarian neoplasms are:

The exact treatment will depend on the stage of the malignant tumor.

The outlook for a person with a benign ovarian cystic neoplasm like cystadenomas and teratomas is generally positive. However, benign tumors can still cause complications like ovarian torsion, or they may recur (come back) after removal.

Mature teratomas can sometimes transition into malignant tumors, most often after menopause. However, this is rare, happening in only 1% to 2% of situations.

An estimated 85% to 90% of ovarian cancers are epithelial ovarian cancers, which are composed of malignant ovarian cystic neoplasms. Ovarian cancers caused by germ cell tumors like teratomas are much less common.

The outlook for someone receiving a malignant tumor diagnosis is largely dependent on the stage of the cancer, making early diagnosis and treatment vital. However, because these tumors often don’t cause symptoms, many have already spread at the time of diagnosis.

According to the SEER database of the National Cancer Institute, the 5-year relative survival rates for ovarian cancer are:

  • 91.9% when the cancer is only in the ovary
  • 71.5% when the cancer has spread into nearby tissues and lymph nodes
  • 31.4% when the cancer has spread to distant tissues (metastasized)
  • 50.9% overall

Ovarian cystic neoplasms are ovarian tumors that have cyst-like qualities. They can include epithelial ovarian tumors and germ cell tumors called teratomas. Most ovarian cystic neoplasms are benign.

However, some may be borderline or malignant. While small benign tumors may be treated with observation, large benign tumors and malignant tumors are treated with surgery.