7cm Mass & Low White Blood Cell Count

Hello Doctor,

I am a 21 year old, non-smoking female. I have had a Mirena IUD in for the past year (Yasmin birth control pill before) and I have had normal pap smears since I was 17 and normal periods since I was 13. I get checked for STDs/STIs every 3 months and have always been clean. Though during this year's pap smear and pelvic exam, my doctor felt a problem and I was sent to have a pelvic ultrasound done, where they discovered a 7cm mass on my right ovary. I am not experiencing any pain or symptoms. It is not an ovarian cyst as the mass is not filled with clear fluid; my doctor is not 100% sure on what it is, she claims it could simply be a cyst filled with blood.

I had several blood tests taken, including the Complete Blood Count and the CA 125 test and a pregnancy test (along with an HIV test). Everything came back negative/normal except for my CBC, in which my white blood cell count was low. My doctor scheduled me for a CAT scan which I will take next Wednesday, along with a second round of ultrasounds next Friday.

Breast cancer or ovarian cancer does not run in my family from what I know of (my aunt who was married into the family has breast cancer, but she's not blood related). The only other problem that I have is hypothyroidism, which I am on medicine for. I am a bit overweight and I have had pre-hypertension which is now under control and I am slowly trying to change my diet and exercise routine.

What could be the problem if the other cancer tests came back negative? Or is there anything else that I should personally be looking?

Thank you so much in advance for any help...

[Annekathryn Goodman, M.D.]

Hi there
thank you so much for your complete information.
You have a great doctor who is taking excellent care of you!

at your age, a 7 cm cyst could be a fluid filled fallopian tube, a benign cyst of the ovary, an endometrioma, and various other benign tumors.

There are a few malignant tumors of the ovary at your age including a borderline tumor of the ovary.  It would be extremely unusual for anything else.

A CT scan is a good next step but ultimately you need a laparoscopy and removal of this cyst. My personal rule is that anything over 4-5 cm should be surgically evaluated. Most things are benign.
please let us know what happens
take care

[Karmz]

Thank you Doctor Goodman!

My CT scan came back clean but I have dermoids. One on each ovary. My doctor did mention removal and has already alerted me to start mentally preparing for surgery to have them both removed as they are quite large. What can I expect with dermoids?

She said since I am only 21 my ovaries will be preserved and they'll take the best precautions to insure minimal damage. I just want to be healthy AND be able to have kids.

[Annekathryn Goodman, M.D.]

sounds like a perfect plan
I hope all goes well
take care