Chocolate Cyst: The Endometriosis Cyst
What Is Endometriosis?
Endometriosis is a condition in which endometrial tissue, which normally comprises the lining of the uterus, is found outside the uterus. The most common places for extra-uterine endometrial tissues to occur are on the ovaries, fallopian tubes, or elsewhere in the pelvis. This tissue, like the normal endometrium, responds to the monthly hormonal cycle. Each month, the ovaries produce hormones which stimulate the growth of endometrial tissue in case of pregnancy. When pregnancy does not occur, levels of these hormones drop off, and the endometrial tissue sloughs off. This material then exits the body as menstrual blood. In the case of endometrial tissue outside of the uterus, however, this exit is not available, and so the blood accumulates. This accumulation of blood can lead to irritation of surrounding tissues and sometimes produces cysts.
What Are Chocolate Cysts?
Endometriomas (also known as chocolate cysts) are cysts in the ovaries formed by endometrial tissue. They are usually filled with old, sludgy-brown blood, hence their moniker. These cysts can vary between 0.4 and 4 inches in diameter and are not necessarily a cause for concern. However, if they rupture, their contents can spill into the ovaries and the pelvic cavity. This can be extremely painful and can also cause some of the organs in the pelvis to bind together. If this happens with the fallopian tubes and ovaries, it can result in infertility. Chocolate cysts can be diagnosed with X-rays or transvaginal ultrasounds. A positive result on a blood test called CA125 can also indicate the presence of a chocolate cyst, but ovarian cancer will also give a positive result, so this could be cause for concern. In these cases, exploratory surgery may be necessary to determine the nature of the problem.
How Can Chocolate Cysts Be Treated?
If chocolate cysts become a problem, they need to be removed. Sometimes, a cystectomy, or removal of only the cyst, will be enough. In other cases, if the cyst is very large, poorly located, or if there are multiple cysts involved, a procedure called an oopherectomy (removal of the ovary) will be required.
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