Paging Dr. Frischer - Cysts

I recently had a request to write a column on cysts. My first thought was that there is no way that an article on cysts could possibly be interesting for my readers. My second thought was the same as my first thought! However, several times each day, I review x-ray results and tell people that they have cysts. Without fail, I’m asked what a cyst is. So here is my chance to address this “highly fascinating” subject, and I can only promise to do my best! A cyst is not a normal part of the body. It has a membrane or wall, and is usually filled with some kind of a material (liquid, semisolid, or gaseous). If it is filled with pus, it is usually not a cyst, but an abscess.

There are hundreds of different kinds of cysts. They can occur almost anywhere in the body, and vary in size. The vast majority have no symptoms and are benign, but occasionally one may contain malignant cells and would therefore be considered cancerous. Some of the more common cysts include sebaceous cysts (found just under the skin), ganglion cysts (found in a joint), breast cysts, ovarian cysts, Baker cysts (found behind the knees), testicular cysts, thyroid cysts, liver cysts and kidney cysts.

Some cysts are easily felt under the skin as a lump or a bump, especially if they are located in the skin or in organs that are just under the skin, like the thyroid gland. For example, many of us are familiar with the sebaceous cyst, found just under the skin. It can become infected and painful.

The treatment for a cyst depends on its underlying cause, and whether or not it is causing problems. Cysts that are found deeper in internal organs may be benign, small, and not produce any symptoms. A ganglion cyst in a knuckle or wrist can remain, unchanged, for years. These cysts may not require any treatment. However, if the cysts become large they can displace or compress tissue or an organ, or obstruct ducts and block normal flows of fluid. The affected organ may show symptoms.

Ultrasound, X-ray, CAT scans, and MRIs help to locate and identify a cyst. A needle biopsy might be used to reduce the size of the cyst, and to determine whether the cyst has malignant cells. A breast cyst can often treated by simply aspirating the cyst with a needle or catheter, causing the cyst to collapse. Other cysts may require removal by surgery, especially if there’s any suspicion of malignancy. Squeezing or popping a cyst on your own can actually make matters worse; if for example, the cyst is in a joint, popping it risks infection and possible joint damage.

Who gets cysts? Risk factors for developing one include genetic conditions, tumors, chronic inflammation, duct blockage, parasites, injuries, organ defects, infections, and obstructions to the flow of fluids. Still, there is no good way to prevent cysts. Science really has no idea why some bodies make cysts, and others do not!

What is the prognosis for a cyst? The vast majority are small and benign. These don’t require treatment and have a good prognosis. Some benign but large or painful cysts may require surgery or aspiration to reduce or eliminate symptoms. Cysts become a problem if they become infected or contain malignant cancer cells, or are located in dangerous places like the brain.

If one day your doctor informs you that you have a cyst, I hope that this column will have given you some measure of relief that it is very likely nothing to worry about.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

 

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Published: Jan. 22, 2015 - Volume 13 - Issue 41