Complex ovarian cyst with solid components

I have a Complex ovarian cyst with solid components and vascular. Size is 3.2cm x 4.5cm x 5cm. My CA125 was normal. Could the cyst be removed Laprascopically or should it be by Laparotomy?

[Machelle Seibel, MD]

The decision to remove a cyst by laparoscopy is always a challenge. It depends on the physician's belief that it is benign which is often done doing laparoscopy versus malignant which is often done with an incision. Occasionally, early ovarian cancer has been removed by laparoscopy.

From the description, it could be either benign or malignant, though the CA 125 being normal makes the chances of it being benign greater. In general, it must be left up to your doctor doing the surgery. If he/she is an oncologist or very experienced laparoscopic surgeon who sees lots of cysts, they might well have a very good idea by just looking at it. Some doctors might choose to remove it laparoscopically into a collecting bag that is pulled tight and removed so there is no spillage. If you are confident in your doctor's experience, ask them to remove it laparocopically if it is at all possible to do. However, it is important to leave them the ability to make an incision and remove it with an abdominal incision if they believe it is in your best interest.
Machelle M. Seibel, MD