By: Akanksha
Dr. Iti Madan and her team performed a delicate surgery to remove a massive 3.5 kg cyst from a patient’s left ovary, in Prayagraj. Large cysts in the abdomen often grow slowly without major symptoms, so patients often mistake them for weight gain or bloating. Such cysts can be removed safely with timely diagnosis and expert surgical care.
A report published by The Times of India on October 12, 2026, stated that the patient experienced immediate relief following the procedure. However, the report does not establish the cyst's histopathology, the precise surgical technique used or whether the ovary was preserved.3
The woman had been experiencing constant heaviness, abdominal swelling, and an abnormally enlarging abdomen for some time. When she arrived at Shanti Vilas Hospital, the doctors conducted a thorough examination, including an ultrasound and other diagnostic tests.
The reports revealed a massive cystic tumor in her left ovary. The cyst had gradually grown large and was putting significant pressure on other internal organs in the abdominal organs.
In a conversation with Dr. Nirainila Joseph of Medbound Times, Dr. M. Vanitha, MD, DGO, Associate Professor, Government Medical College, Thoothukudi, and Consultant Obstetrician-Gynaecologist, Royal Hospitals, Tirunelveli, Tamil Nadu, India, explained, “A self-diagnosis is possible only when that cyst becomes very large. The ovary, being a pelvic organ, is not clinically palpable even by a doctor, unless it gets enlarged to more than twice its normal size. Only when the cyst enlarges and the ovary comes across the pelvic bone, patients feel heaviness or stretching pain in the lower abdomen. So, self-diagnosis is somewhat difficult.”
Ovarian cysts cannot be reliably identified by symptoms alone. An ultrasound can help establish a cyst's size, location and appearance, including whether it contains fluid or solid components. Depending on the findings, a clinician may recommend follow-up imaging, blood tests or further assessment.3
Also Read: What to Expect During and After Cyst Removal Surgery? A Quick Overview!
An ovarian cyst is a small sac filled with fluid or other semisolid material that forms on or inside an ovary. Most ovarian cysts are benign (non-cancerous) and do not cause any pain.
Some cysts resolve without treatment, while others may persist, grow or require medical assessment. The appropriate management depends on the cyst's size, appearance, symptoms and the patient's age and menopausal status.3,4
The most common type of ovarian cyst is the functional cyst. They form as a result of natural changes during the menstrual cycle.
These are sometimes referred to as simple cysts and occur as part of the normal ovulatory cycle. Functional cysts usually shrink within a few months without requiring treatment. They include:
Follicular cysts: An egg grows within a small sac called a follicle. During ovulation, this follicle ruptures to release the egg. A follicular cyst forms when the follicle fails to release the egg and continues to grow.
Corpus Luteum Cysts: Post-ovulation, the ruptured follicle transforms into a structure called the corpus luteum. If pregnancy does not occur, the corpus luteum naturally breaks down; but in some cases, if the opening seals, fluid can accumulate and form a cyst.
Not all ovarian cysts are linked to the menstrual cycle. They aren’t always signs of underlying pathology, but may require regular monitoring. Other types include:
Cystadenomas: These form on the surface of the ovaries and may contain a thin, watery fluid or a thicker, mucus-like substance.
Dermoid Cysts (teratomas): These are cysts that contain cells such as hair, teeth, skin or sebaceous material. They are typically benign.
Endometriomas: These cysts are filled with old menstrual blood (referred to as “chocolate cysts”) and develop due to endometriosis.
Malignant (cancerous) cysts: Some ovarian masses are cancerous, but their nature cannot be determined from size alone. Ultrasound findings and other clinical assessments help doctors evaluate the likelihood of malignancy. Suspected ovarian cancer requires appropriate specialist assessment.2
The causes vary according to the type of cyst.
Abnormal cell reproduction: Unusual cell growth can cause conditions like dermoid cysts or cystadenomas to develop.
Endometriosis: Endometriomas often form on the ovaries in cases of advanced endometriosis.
Polyendocrine metabolic ovarian syndrome (PMOS): PCOS/MOS is a hormonal and metabolic condition associated with irregular ovulation and multiple small follicles in the ovaries. It is not the same as having a single, large ovarian cyst.4
Pelvic inflammatory disease (PID): Severe pelvic infections can spread to the ovaries, leading to abscesses or infected cysts.
Pelvic pain or a dull ache in the lower back
A feeling of fullness or bloating in the lower abdomen, which may be localized to one side.
Pain during sexual intercourse (dyspareunia)
Painful periods or irregular periods
Difficulty with bowel movements or needing to urinate frequently
Feeling full after eating only a small amount of food.
Persistent or recurring symptoms warrant medical assessment. These symptoms are not specific to ovarian cysts and can occur with other conditions, so they should not be used to make a self-diagnosis.
Malignancy (Cancer): Ovarian cysts that develop after menopause are significantly more likely to be cancerous than those that form during the reproductive years.
Ruptured Ovarian cysts: A cyst can rupture or burst. While some ruptures produce minimal symptoms, they can frequently trigger severe pain, internal bleeding, dizziness, or weakness. Large cysts carry a higher risk of rupture.
Ovarian torsion: A large cyst can cause an ovary to twist on its supporting ligaments, cutting off its blood supply. Symptoms include sudden, severe pain and nausea and vomiting.
Highlighting the risks of larger cysts, Dr. Vanitha noted: “Larger ovarian cysts can result in acute abdominal pain, especially if they twist (torsion), accompanied by sudden vomiting, fever, and difficulty in walking. This acute pain is localized to the loin area, typically on the right or left side where the cyst is located. Immediate medical attention is crucial if torsion pain occurs.”
Also Read: Johnson & Johnson Ordered to Pay $250,000 in Talc Ovarian Cancer Trial
The hospital’s renowned gynecologist and obstetrician, Dr. Iti Madan, and her team, recognizing the seriousness of the situation, immediately decided to operate. The massive 3.5 kg mass was safely removed without causing any damage to other organs. Following the surgery, the patient's condition was completely stable, and she is recovering quickly. The hospital director mentioned that such complex surgeries are readily achievable thanks to the modern infrastructure and facilities available at the hospital.
Regarding treatment strategies for non-resolving masses, Dr. Vanitha explained, “Benign cysts don't respond to any hormonal treatment and they need some sort of surgical management if they are not resolving in size. Nowadays, we are following the laparoscopic surgical procedure for a benign cyst, and for cancerous growth, the treatment has to be done with a surgical oncologist.”
Treatment depends on the type and characteristics of the cyst. Some cysts can be monitored with follow-up ultrasound examinations, while surgery may be considered for cysts that are large, persistent, symptomatic or suspicious for malignancy. Depending on the case, surgery may involve removing only the cyst or removing the affected ovary. The appropriate approach is determined by the treating team after clinical assessment.
References:
1. MedBound Times. “Ovarian Cysts: A to Z—Everything You Need to Know.” MedBound Times. https://www.medboundtimes.com/medicine/ovarian-cysts-a-to-z-everything-you-need-to-know.
2. Cleveland Clinic. “Ovarian Cysts: Causes, Symptoms, Diagnosis & Treatment.” Cleveland Clinic. Accessed October 13, 2026. https://my.clevelandclinic.org/health/diseases/9133-ovarian-cysts.
3. American College of Obstetricians and Gynecologists. “Ovarian Cysts.” Accessed October 13, 2026. https://www.acog.org/womens-health/faqs/ovarian-cysts.
4. NHS. “Ovarian Cyst Treatment.” Accessed October 13, 2026. https://www.nhs.uk/conditions/ovarian-cyst/treatment/.
5. American College of Obstetricians and Gynecologists. “Polycystic Ovary Syndrome (PCOS).” Accessed October 13, 2026. https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos.
(Rh/APC/MSM)