Post-menopause complex cyst and endo fluid

[Rowana77]

Just got results of my latest ultrasound, and it shows a 2.7 cm complex cyst on R ovary (we are assuming this is the same cyst imaged in Oct, which was then 2.5 cm) -- AND fluid in the endometrial canal. I'm 52, menopausal 3 years. My dr referred me to OB/GYN; I can't get in for 2 wks, so now must wait/worry. Have experienced pelvic pressure/discomfort, intermittent gas, burping/bloaty feeling, since late Sept, but it was off and on -- now low-key pressure seems pretty steady. In interim have had 2 CT scans, which show no abnormalities aside from cyst.  I just got out of 3 days in hospital for what turned out to be a SBO -- treated w/IV fluids for 3 days, and it resolved. Either SBO is a totally separate problem, or it's not and is somehow related to all the pelvic stuff going on. I have fears of giant tumors which have worked their way up from the pelvic region into the small bowel, but the drs at the hospital said that was unlikely and that in all the imaging, SOMETHING bad would probably have been seen.They also said that if this were cancer, symptoms of gas/bloat, etc. wouldn’t be intermittent but would be steadily worse;they chalked up my symptoms of periodic gas/bloating to the SBO, which is most likely due to scar tissue from previous pelvic surgery I had 16 years ago (to remove benign ovarian cysts).On the upside, my CA-125 has been taken twice, and scored a 6 and a 5.But that can be misleading too (though I hear it’s more reliable past menopause?).Also on up side, have had NO post-menopausal bleeding at all, no weight loss/loss of appetite, and no fatigue--in fact, lately I feel super-energetic (though, of course, worried and losing sleep about all this!).The only thing I have is nagging feeling of pressure in pelvis, intermittent gas/burping, and of course the recent intestinal obstruction and the imaging results with the persistent complex ov cyst and endo fluid.I’m REALLY worried. Is there any likelihood at all that this is all something benign? Rowana

[Machelle Seibel, MD]

While it isn't possible to say what you have from the information you have mentioned, it is much more unlikely to be cancer of the ovary because the size has basically stayed the same. Also, the imaging studies you had done didn't show anything. Bloating due to cancer of the ovary is usually due to the fact that the ovary gets big and pushes up on the intestines. But that isn't the case for you. Also, I'm assuming SBO is small bowel obstruction. That would certainly cause your intestinal symptoms of gas and burping. Fluid in the uterus is fairly common and is usually due to something benign.Your doctor might want to check the lining to see why the fluid is there. Despite how uncomfortable you feel and the worry this is causing you, there is a high likelihood this will all turn out to be benign and you will be fine. I certainly hope so.
Machelle M. Seibel, MD

[Rowana77]

Well, have now had endometrial biopsy (nothing but fun!) and awaiting the results.  My gynocologist said the ovarian cyst was "nothing to worry about" -- he wants to take a wait and watch attitude toward it.  He was more concerned about the thickened endometrial lining, hence the biopsy.  Crossing fingers it's not cancer and that we can treat it with hormones!  - Rowana

[cahtrbox]

This sounds like my case exactly!! I had robotic surgery and am on the mend. I am now having hotflashes BIG time. My RT ovary was the size of a lemon and Rt was the size of a prune. I had a CA 125 and it was 23. Thank god all was well and none of it was cancerous. I had my surgery on the 30th of Jan and don't let anyone tell you it is minor surgery. It is tough to recover and be easy on yourself. I hope I have helped you, but I sound just like your case and everything worked out!!!

[Rowana77]

I should add that I also have a bunch of gnarly fibroids in my uterus.  And I have Hashimoto's thyroiditis, which may be neither here nor there in this discussion -- treating that with Levothroid.  But I thought I'd throw that in.  Sorry for rambling, but honestly, I've lived with these symptoms for months and now the worry and waiting is really wearing on me!  Do you think, between the fibroids, the ovarian cyst and the endo fluid, there's any chance of avoiding hysterectomy?  Could possibly a fibroid (submucosal?) be causing the endometrial fluid?  Thanks for putting up with all these questions -- I know this is kind of a complicated case but I thought I should give my whole history.  Rowana