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21 cm cyst
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21 cm cyst

I am 19 years old now and had just undergone an ultrasound examination awhile ago.. i feel no symptoms..my menstruation is regular and i dont have pains.. except for having bloated stomach.. i thought it was just fats.. it says on my sonographic findings that : there is a huge, well-defined, cystic mass with few thin internal septations in the abdominopelvic cavity aprox 21cmx19x10. no definite calcifications noted.
IMPRESSION:
>abdominopelvic cystic mass(21 cm) probably ovarian origin.
what this means?
im very much worried by not having a baby..im still single..my bf is in abroad..im still studying in college,.  :-(
someone help?


This discussion is related to 20 cm ovarian cyst.
Tags: Cyst, 21, ovarian, ultrasound
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I am sorry you have to go threw this it is very stressfull to have this hanging over your head especially at your young age. I hope you have a good support system as this is alot to be taking on by yourself.
Keep in mind most cysts are benign!!  Since your transvaginal sonogram(TV) showed a complex cyst on your ovary warrants a very thourough work up to rule out any other potential issues.
My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 and I know what it feels like to not know what the next step is. Here is a quick overview.

Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx). A transvaginal ultrasound (TV) is the most valuable diagnostic study in the evaluation of an adnexal or pelvic mass/suspicious cysts.  
An MRI is usually the next test that should be given as they are more precise when read by the right radiologist.
The blood test CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other causes of inflamation (inflammation)..
There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS. Please keep in mind if and only if you have a dx of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing tumors as opposed to epitheal.
Unfortunately with any type of suspected ovarian mass/tumor/ suspicious cyst(s) surgery will be the only way for the Dr's too make a definitive Dx. It is NOT recommended to biopsy any ovarian mass/tumor/suspicious cyst as it can rupture and seed the pelvis with cancer cells if that what it turns out to be.
Please make sure you have your blood drawn for the following blood tests,Inhibin A&B, CA125 and CEA so at the very least you have baseline blood work.
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Since there is some suspicion based on your TV-sonogram I would immediately find a good GYN/Oncologist surgeon. I am not suggesting what you have is cancer but studies have shown that treatment of ovarian cancer by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients.  This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal.
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Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive (aggressive) and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best.
Kevin
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