Ovarian Cyst with Papillary Muscles

[Pammy34]

Hi I am 42 years old, went to GYN Doc d/t vaginal hemorrhaging..yes he said so himself, had a trans vag US done and found an ovarian cyst nearly 4cm fluid filled with several areas of papillary muscles, uterus enlarged with 2cm thickness of the lining said it contains 153ML of Fluid. Put me on BC pills, even though I am a smoker, family HX of MI and DVT..but said if I want to stop bleeding I have to take it..okay so I quit smoking so I can die of something else.  Oh I was dx'd with uterine fibroids 8-10 years ago..asked for a d+c then but no need for me to worry, I began having ovarian cyst at 17 years of age..no biggey..I am used to them..but this one has me worried, if it is not gone when I have repeat US in 4 weeks my ovary needs to come out??????  What is the big deal ?? Should I be thinking  about cancer?????  I am starting to....  looking for a gyn/onc doc at the present time.  Please explain to me what it means when the cysts have papillary muscles and the correlation with cancer.
I am an RN,CEN,CCRN and work in the ER but GYN/CA stuff is not my specialty.
Thanks in advance,
Pam

[Annekathryn Goodman, M.D.]

Dear Pam,

You have two separate gynecologic issues going on:
-abnormal bleeding and an associated thickening in the lining of your uterus. You should get a biopsy of the lining to understand what is causing the thickening. it could be due to a polyp or a premalignant change called endometrial hyperplasia or a malignancy of the lining of the uterus. A biopsy can be done in the office or can be done in the operating room. I usually also do a hysteroscopy which is looking inside the uterine cavity (endometrium to make sure I do not miss anything on a blind biopsy. Birth control pills can help slow bleeding but diagnostics are very important
-You have an ovarian cyst. I agree with a repeat ultrasound. if it has not changed it should be evaluated by laparoscopy.  I am glad that you stopped smoking!!
take care

[Pammy34]

I also forgot to mention for many years I have suffered from sudden onset of SEVERE abdominal pain I call it pressure  I would rate it 8/10, it incapitates me, with 800mg of motrin and heat I can beome functional in 20-30 minutes. no reason known for this, but if this ovarian cyst is a bad thing then it would all make sense.  I used to be faithful at having the yearly gyn check but my beloved ob/gyn Doc died and his partner lost his license and i really just haven't connected with another just yet.

[Pammy34]

Thank you for the information.  Can you tell me what it means when the ovarian cyst has papillary muscles on it??  This is really the part that has me worried.
Thank You so much,
Pam

[akg]

Hi There,
I think it must say something different like papillary excresences. that means that within the cyst, there are some solid elements that have a polyp like appearance

[Pammy34]

Well after some coersing my doc decided that I need a hysteroscopy and biopsy of my uterine lining.  he told me to take 3 ibuprofen before coming on that day........is this typically the treatment for this procedure?  I am not sure I want to do it if so.  Well he added Provera and am already on loestrin24 the bleeding finally stopped.
so procedure date is 4/17, will there be any after pain? I have missed alot of work recently due to this.
Please Let me know,
Pam