cyst is a cavity that contains a liquid or semi-solid substance that forms in an organ or tissue. The vast majority of cysts are not cancerous, but some can disrupt the functioning of an organ and cause pain.
There are several types of cysts: the most common are found in the skin, ovaries, breasts and kidneys.
Two types of cysts occur under the skin: the epidermoid cyst (formed from epidermal cells) and the sebaceous cyst (formed in the sebaceous glands). These cysts have the appearance of small smooth bumps of the same color as the skin or rather “yellow-white”.
They appear on the face, on the neck, on the trunk, and sometimes in the genital area. It can also be found in the back and limbs. Mostly painless, these cysts grow slowly and usually require no treatment.
The pilonidal cyst is a small pocket containing hair and skin debris located above the intergluteal furrow. If they become infected, these cysts can be very painful and require intervention. Pilonidal cysts occur more commonly in young men and the problem is often recurrent. People who spend long periods sitting, such as truck drivers, are at higher risk of developing this type of cyst.
The synovial cyst appears most often on the back of the wrist or at the base of the fingers, spontaneously or following a trauma. Its size varies from a few millimeters to several centimeters and it can be painful during compression or during certain movements. These cysts are not dangerous and usually go away on their own after a few weeks or months. Minor surgery may be performed to remove the cyst.
The popliteal cyst (or Baker’s cyst) is a pocket of articular fluid (synovial fluid) that appears behind the fold of the knee. Depending on its volume, the cyst can cause discomfort or pain behind the knee, such as tension, difficulty walking or limitation of flexion movements. Rarely, it can compress some nerves and cause swelling or tingling in the leg. Most of the time, the popliteal cyst is linked to arthritis or a knee injury.
|The joints and tendons, such as the knee and wrists, are lined with a membrane called synovial tissue. This secretes a viscous liquid, the synovial fluid , which allows to nourish and lubricate the joints. The synovial tissue can spontaneously or following trauma, form pockets that fill with synovial fluid, causing cysts.|
The cyst of Bartholin’s gland is manifested by a lump or pain at the entrance of the vagina. Bartholin’s glands produce a protective and lubricating fluid that can sometimes become infected and cause swelling or cyst formation. This cyst is not serious and can affect all women at some point in their lives.
An ovarian cyst is a pocket filled with fluid that develops on the surface or inside of an ovary. Ovarian cysts are very common in women and are rarely cancerous before the age of 50.
There are several types of ovarian cysts. The functional cysts appear during the ovulation cycle (release of an egg from the ovary). Most pain-free, harmless and non-cancerous, they usually go away on their own after 2 or 3 menstrual cycles.
Other types of cysts are due to benign tumors such as dermoid cysts , the endometriosis cysts (or endometrioma) in women with endometriosis. The polycystic ovary syndrome is not due to cysts but the follicles on the ovaries that make up the volume.
Some benign ovarian cysts may increase the risk of ovarian cancer. Some malignant tumors and some ovarian cancers start with an ovarian cyst.
A Naboth cyst (or Naboth’s egg) is a pocket filled with mucus that forms on the lining of the cervix (The cervix is lined with mucus-producing glands). This type of cyst is common in women after delivery or in postmenopausal women whose uterine lining becomes thinner with age. This cyst has virtually no symptoms and is usually detected during a routine pelvic exam. It presents no risk to health.
A breast cyst is a mass containing fluid produced by the mammary glands. It can be small and insensitive to the touch or sometimes bigger, oval or round, 1 cm or 2 cm in diameter and moves easily under the fingers. The cyst tends to become hard and sensitive before the menses. Having a breast cyst is not a risk factor for breast cancer.
A spermatic cyst (or spermatocele) is a sac that forms in the epididymis, (the small tube located in the testicle that collects and transports sperm). Usually painless and non-cancerous, these cysts contain a milky or clear liquid that may contain sperm. These cysts are common in men, do not affect fertility, and usually require no treatment.
A renal cyst is a fluid pocket that forms in the kidneys. The most common are simple (or solitary) cysts. They cause no complications or symptoms. Some people develop a multitude of renal cysts, a hereditary abnormality called polycystic kidney disease. This condition can cause high pressure and kidney failure.
The pancreas is an organ located behind the stomach that produces hormones and enzymes that help digestion. A pancreatic cyst (or pancreas cyst) is a small pocket filled with fluid in the pancreas that is often formed as a result of acute or chronic pancreatitis (an inflammation of the pancreas).
Most pancreatic cysts are not cancerous and cause no symptoms. Some pancreatic cysts can still be cancerous. They are diagnosed with a sample of the fluid in the cyst or by monitoring any changes in shape or size. A doctor may sometimes recommend the removal of the cyst by minor surgery.
The symptoms of a cyst
- Small, smooth skin-colored lumps or “yellow-whites” appearing on the face, neck, trunk, back, limbs and sometimes in the genital area. They can reach the size of a golf ball.
- The cysts of the skin are usually painless. If the cyst breaks and becomes infected, it can become swollen and painful, become reddish and become sensitive to touch. The cyst has slow growth.
When a pilonidal cyst is infected:
- A swollen mass (abscess).
- A redness on the skin.
- A flow of blood or pus.
- A nauseating odor from the flow of pus.
- A cyst appearing suddenly and growing rapidly.
- A cyst measuring approximately 1 cm in diameter, sensitive to the touch.
- Pain or weakness to the touch.
- A feeling of discomfort, tension or swelling behind the knee during flexion.
- More rarely, swelling or tingling in the leg.
- If the cyst dies, significant pain can be felt behind the knee and along the leg. There may also be redness and swelling of the calf that may suggest phlebitis.
Bartholin’s Gland Cyst
- Sensitive swelling on one side at the entrance of the vagina.
- Pain and discharge of pus if the cyst gets infected.
- Most of the time without any symptoms.
- Abdominal pain or bloating.
- An irregular menstrual period .
- Nausea or vomiting.
In case of rupture of a cyst
- Sudden and intense pain from one side to the lower abdomen.
Cervix, Naboth cyst
- Usually no symptoms.
- Mostly without symptoms.
- A hard and sensitive ball that changes size and sensitivity during the menstrual cycle.
- Usually without any symptoms. The cyst usually does not increase in volume.
If the cyst gets bigger, it can cause:
- Pain or discomfort to the affected testicle.
- A feeling of heaviness in the affected testicle.
- Swelling behind and above the affected testicle.
- Often without any symptoms.
- Back pain.
- Abdominal pain, when the cyst becomes very big.
- Blood in the urine.
People at risk for Cyst
Spermatic cyst (or spermatocele)
- Men aged 40 to 60 years old.
- The risk of developing a kidney cyst increases with age.
- An inactive lifestyle.
- Sports or an activity that requires extended sitting periods.
- An excess of body hair.
- Very stiff and rough hairs.
- A lack of hygiene.
- People who have had acute or chronic pancreatitis. Alcohol abuse and gallstones increase the risk of getting pancreatitis.
Prevention of a cyst
The appearance and growth of most cysts can not be prevented.
Ovarian cysts can not be prevented. However, regular examination of the pelvic area ensures that changes in the ovaries are diagnosed as early as possible. Be alert to any changes in the symptoms that usually accompany your menstrual cycle.
The spermatic cysts can not be prevented. However, a scrotal self-examination is recommended every month, to detect any changes in the scrotum, for example the appearance of masses.
Medical treatments of a cyst
The need for treatment depends on the type of cyst, where it occurs and the symptoms. When symptoms are non-existent, no treatment is usually necessary.
Cyst of the skin
When a cyst is very large or swollen, drainage is sometimes recommended. Under local anesthesia, a doctor introduces a needle or makes a small incision to empty the contents of the cyst. The doctor can also make an incision to remove the wall of the cyst, which prevents its recurrence. When the cyst is infected (an abscess), it is best to drain it.
A doctor may make a small incision to drain the cyst after anesthesia of the affected area.
When the cyst appears recurrent or has complications (persistence of an infection, appearance of fistula …), it is sometimes necessary to proceed to the complete removal of the cyst. This procedure requires more time and some precautions to allow the wound to heal well.
Painful cysts can be relieved with ice applied directly to the wrists. Drugs such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can also relieve pain. When pain or weakness is felt by touch, a doctor may perform a puncture to remove the fluid from the cyst, which may however reappear. In some cases, surgery is needed to remove the cyst.
Often, the popliteal cyst is cured spontaneously without any treatment. Because the popliteal cyst is often associated with knee arthritis or cartilage tear, treatments usually involve arthritis or some other underlying cause. If the cyst is very large, a doctor may perform a puncture to remove the fluid from the cyst (this puncture is usually done with an ultrasound) or inject cortisone into the knee to reduce inflammation. Surgery is usually avoided to remove the cyst because the risk of recurrence is too great.
Bartholin’s Gland Cyst
In case of pain, warm compresses can be applied to the cyst. Pain medication (acetaminophen, ibuprofen) may be prescribed.
In case of redness, fever or if pus flows from the cyst, a doctor may make an incision in the cyst to allow a flow of pus and may prescribe antibiotics.
The treatment of ovarian cysts depends on the age, type, size of the cyst and the symptoms experienced:
- Most ovarian cysts do not require any intervention. Regular review allows for follow-up. Most cysts disappear on their own after a few months. Rupturing a cyst can cause fairly strong pelvic pain that can be relieved with pain medications (acetaminophen, ibuprofen), but may sometimes require more potent analgesics (opioids such as morphine) for a few days.
- A doctor may sometimes recommend the use of the contraceptive pill (anovulants) to reduce the risk of developing new cysts during subsequent menstrual cycles. This method has the advantage of also reducing the risk of ovarian cancer.
- In case of larger cyst, which increases in volume, which persists during 2 or 3 menstrual cycles or which is painful, a surgery can be recommended:
- The cyst can be removed without removing the ovary (removal of an ovarian cyst) or removing the affected ovary (ovariectomy).
- If a cystic mass is cancerous, the doctor may recommend removing both ovaries and the uterus (hysterectomy).
Naboth cysts usually do not require any treatment.
- Usually no treatment is needed for a breast cyst that does not carry a breast cancer risk. When the woman has not reached menopause, the doctor may recommend regular follow-up, in order to check if the cyst resolves itself.
- Both by diagnostic measure and by treatment, the doctor can aspirate the liquid contained in the cyst with a fine needle. This simple and painless operation will quickly remove the cyst and symptoms.
- If a body becomes enlarged and persists for 2 or 3 menstrual cycles, it is better to have more extensive examinations such as a cyst biopsy, mammogram or breast ultrasound to check for cancer. Surgery is sometimes recommended to remove the cyst.
- Use of the contraceptive pill can help regulate menstrual cycles and reduce the recurrence of breast cysts.
Although sperm cysts rarely go away on their own, most do not need treatment and they do not cause pain or complications. In pain, medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are recommended.
If the cyst reaches a size that causes pain or discomfort, surgery is sometimes recommended to remove the cyst from the epididymis or remove the fluid from the cyst. There are certain risks to this surgery: damage to the epididymis or vas deferens (the prolongation of the epididymis behind the testicle) can cause fertility problems. Also, surgery is usually performed in men who have passed the fertility age. A cyst may also reappear after surgery.
Kidney cysts that do not cause symptoms usually do not require treatment. The doctor may recommend periodic monitoring of the kidneys to check for any changes in the cyst.
When a kidney cyst causes symptoms, a doctor may:
- Drain the cyst with a needle inserted into the skin.
A sample of the liquid can be removed and analyzed in the laboratory. This procedure is performed using ultrasound ultrasound. In case of polycystic kidney disease, regular monitoring is necessary to verify the proper functioning of the kidneys. People who develop kidney failure with hereditary cysts should be treated with dialysis or have a kidney transplant.
- Remove the cyst using laparoscopic surgery (by a small incision in the skin and a camera follow-up).