Peritoneal Inclusion Cyst (PIC)
Definition - What does Peritoneal Inclusion Cyst (PIC) mean?
Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. It is most frequently encountered in women during their reproductive years.
A peritoneal inclusion cyst can grow as large as 20 cm in diameter. However, it is not thought to disrupt the fertility potential of a woman.
FertilitySmarts explains Peritoneal Inclusion Cyst (PIC)
Normally, the double lining called peritoneum that covers the abdominal and pelvic organs, uses up the fluid produced by the ovaries during the period of ovulation. However, certain conditions, such as pelvic inflammatory disease, previous abdominal or pelvic surgery, infection, or endometriosis can damage the peritoneum as well as trigger the formation of adhesions within the abdomen and pelvis. The ovaries continue to produce fluid but the damaged peritoneum can no longer take in (or absorb) the fluid, which instead builds up and gets trapped by the surrounding adhesions. This mechanism yields a complex cystic pelvic mass, called PIC.
Conditions that induce high estrogen levels like pregnancy or use of estrogen-containing oral contraceptive pills are a risk for recurrence or enlargement of a preexisting peritoneal inclusion cyst.
Women with peritoneal inclusion cyst usually complain of pelvic pain, fullness, or a pelvic mass. Around 10% are discovered incidentally on ultrasound examination. Even the largest cysts do not preclude fertility. However, the presence of pelvic adhesions may cause difficulty getting pregnant.
The cyst is usually diagnosed on a transvaginal ultrasound.
The treatment options for PIC are observation, hormonal medications, imaging-guided drainage, imaging-guided sclerotherapy, and surgical removal via laparotomy or laparoscopy.