Cysts are formations resembling closed capsules or sacs in the body, usually filled with fluid, dead skin, or air. They are not a normal part of the tissue in which they develop, but are separated by a distinct membrane. The size of cysts varies, ranging from microscopic to large enough to displace internal organs. Most cysts are benign (non-cancerous), but some are cancerous or precancerous and need to be removed. If a cyst is filled with pus, it indicates an infection and may form an abscess.

Why do cysts form and what are the symptoms?

They can appear anywhere on the body. Cysts often result from blocked sebaceous glands, infections, genetics, tumors, cellular damage, blocked ducts, chronic inflammatory conditions, or developmental defects in organ formation during embryonic development. Many cysts cause little to no symptoms or pain unless they become infected or rupture. They are usually discovered when a person first feels an abnormal lump under the skin. Internal cysts can go unnoticed until an MRI or ultrasound reveals their size and location. Breast cysts may cause pain, and brain cysts can lead to headaches. For large cysts causing problems, doctors usually recommend surgical removal. Another treatment option is draining or aspirating the cyst with a large needle. If a cyst is suspected to be cancerous, the cells in the fluid or the wall of the cyst are examined via biopsy.

What are the most common types?

There are hundreds of types of cysts that can appear in the body, and the most common include:

•   Epidermal cysts (on the skin)
•   Baker’s cyst behind the knee
•   Cysts within the thyroid gland
•   Glandular cysts inside the eyelid
•   Ovarian cysts, including dermoid cysts
•   Ganglion cysts of joints and tendons
•   Sebaceous cysts of small glands in the skin
•   Pineal cysts within the pineal gland of the brain
•   Tarlov cysts, also known as meningeal or perineural cysts
•   Pancreatic cysts – fluid collections within the pancreas
•   Breast cysts as part of benign proliferative disease
•   Bartholin’s cysts, an enlargement of small glands near the vaginal opening
•   Polycystic kidney disease, an inherited condition in which the kidneys contain numerous cysts.

How is it determined whether cysts are cancerous?

To determine if a cyst may be cancerous, it is necessary to measure CA-125 levels, which is a tumor marker used to monitor disease in patients with epithelial ovarian cancer. If the test reveals elevated protein levels, it may indicate ovarian cancer. However, some ovarian cancers may not produce enough protein to be detected by the test. Additionally, non-cancerous conditions such as uterine fibroids and endometriosis can also increase CA-125 levels. Non-cancerous causes of elevated CA-125 are more common in women under the age of 35, while ovarian cancer is rare in this age group. Therefore, the CA-125 test is usually recommended for women over 35 who are at higher risk of the disease and have a cyst that is partially solid.

Can lumps be dangerous if left untreated?

For example, if a cyst appears with multiple lumps and openings on the skin, a dermatologist’s examination is necessary because such growths can be associated with more serious health conditions and require immediate treatment to prevent progression. Cysts on the body smaller than 1 cm may not require treatment if they do not cause problems, but they should be monitored. However, when they begin to grow, it is worth removing them before they become too large, as timely treatment reduces the size of the scar. Cysts can become painful and infected. If this happens, the doctor prescribes oral antibiotics, waits for the cyst to “settle,” and then schedules surgery to remove it when the skin is less inflamed. It is important to discuss the method of excision with the surgeon, as some surgeons attempt to make small incisions and squeeze the cyst out. This method is only effective for very small cysts. The problem is that it can leave part of the cyst wall behind, which may later cause the cyst to reoccur.