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Ovarian Cancer (Expert Forum)
Doctors don't agree on what to do with small Dermoid etc, opinion please
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.
Doctors don't agree on what to do with small Dermoid etc, opinion please
by Suett, Nov 27, 2006 12:00AM
Hi All,
I am confused. Maybe you can help.
Here is my ultrasound report regarding a possible Dermoid.
History: 51 year old female with excessive vaginal bleeding. Rule out Fibroids.
Findings: The uterus is slightly prominent measuring 10.0 x 4.6 x 5.8 cm. The endometrial stripe measures 1.4 cm. No uterine mass seen.
The right ovary is normal measuing 2.2 x 1.5 x 1.9 cm. The left ovary is very rounded. It measures 2.4 x 2.6 x 2.4 cm. Neither ovary is well visulaized transvaginally. However, there does appear to be a focal central echogenic mass within the left ovary mesuring approximately 1.3 x 1.6 cm. There is no free fluid in the cul-de-sac.
Inpression: Findings suggesting a round echogenic mass within the left ovary. This could be due yo a small dermoid. A follow-up ultrasound is recommended to reevaluate the left ovary if clinically indicated.
My Gynocologist/Surgen would like to have the left ovary removed(She says no sense waiting at my age). She also suggested a complete hysterectomy to remove the large uterus to stop my bleeding. Plus, she want to d o the surgurey Dec 20!. Nervous about Holiday staff!
My Hemotologist/Oncologist said to wait 8 weeks to see if mass grows. He see no indication from the report that the uterus is adding to my bleeding problem. He wants to wait and watch the possible dermoid because it is so small. He says he considers himself a "Minimalist"
Both of these docs are from Kaiser Permanente and work at the same hospital.
Please any help or suggestions would be deeply appreciated.
Thanks so much,
Suett
I am confused. Maybe you can help.
Here is my ultrasound report regarding a possible Dermoid.
History: 51 year old female with excessive vaginal bleeding. Rule out Fibroids.
Findings: The uterus is slightly prominent measuring 10.0 x 4.6 x 5.8 cm. The endometrial stripe measures 1.4 cm. No uterine mass seen.
The right ovary is normal measuing 2.2 x 1.5 x 1.9 cm. The left ovary is very rounded. It measures 2.4 x 2.6 x 2.4 cm. Neither ovary is well visulaized transvaginally. However, there does appear to be a focal central echogenic mass within the left ovary mesuring approximately 1.3 x 1.6 cm. There is no free fluid in the cul-de-sac.
Inpression: Findings suggesting a round echogenic mass within the left ovary. This could be due yo a small dermoid. A follow-up ultrasound is recommended to reevaluate the left ovary if clinically indicated.
My Gynocologist/Surgen would like to have the left ovary removed(She says no sense waiting at my age). She also suggested a complete hysterectomy to remove the large uterus to stop my bleeding. Plus, she want to d o the surgurey Dec 20!. Nervous about Holiday staff!
My Hemotologist/Oncologist said to wait 8 weeks to see if mass grows. He see no indication from the report that the uterus is adding to my bleeding problem. He wants to wait and watch the possible dermoid because it is so small. He says he considers himself a "Minimalist"
Both of these docs are from Kaiser Permanente and work at the same hospital.
Please any help or suggestions would be deeply appreciated.
Thanks so much,
Suett
Doctor's Answer
by Annekathryn Goodman, M.D., Nov 27, 2006 12:00AM
, Nov 27, 2006 12:00AM
Hi There,
First of all, why are you seeing a hematologist-oncologist? Do you have cancer or a blood problem?
Context is everything!
Based on your ultrasound report, I would say at very least, you need a D&C (dilation and curettage) and a hysteroscopy to look inside the uterine cavity.
Based on the context of your other medical problems (like for instance if you a have experienced breast cancer), it may be reasonable to consider removing your ovaries. Without that context, I would say, the ovarian issue is secondary to sorting out why you are bleeding. An endometrial stripe of 1.4 cm is very thick. It is important to rule out a malignancy inside your uterus.
best wishes to you.
First of all, why are you seeing a hematologist-oncologist? Do you have cancer or a blood problem?
Context is everything!
Based on your ultrasound report, I would say at very least, you need a D&C (dilation and curettage) and a hysteroscopy to look inside the uterine cavity.
Based on the context of your other medical problems (like for instance if you a have experienced breast cancer), it may be reasonable to consider removing your ovaries. Without that context, I would say, the ovarian issue is secondary to sorting out why you are bleeding. An endometrial stripe of 1.4 cm is very thick. It is important to rule out a malignancy inside your uterus.
best wishes to you.
No breast cancer, just Chronic fatigue, Lyme, Babesia, and especially the low ferritin for at least 10 years. Just recently slightly anemic.
Thank you so much for your help any other suggestions?
Suett
I am not sure if this will make any difference with your thoughts but I am sorry I did not tell you that I am still menustrating and I was on my 20th day of my cycle.
Thanks again for all your help,
Sue
well, I still think you need to have a uterine evaluation. Removing the uterus will definitely solve the problem if you are bleeding so heavily that you are anemic. But if you are not ready to do that, you need to have a biopsy of the lining of the uterus.
take care
Hudson
If the utrine biopsy turns out normal do you still think I should still have the ovary with the dermoid in it removed right away?
kindly,
suett
If the 1 cm cyst is not bothering you, I would probably just check again in three months. if it is not changing in size and you are not having pain, I would leave it alone. If it is changing or you have symptoms, that is a reason to remove it
best wishes