Adnexal cyst....postmenopausal

[sophie50]

I have had blood tests come back for a while now with high calcium levels.  PTH was tested and came back suppressed with high calcium.  I had a CT to rule out malignancy.  (Still believe this is a  hyperparathyroid issue with the calcium and not related to the incidental CT finding).

I am menopausal.  My last period was May 2009 but I spotted slightly Sept. 2009 when HRT was started.  At that time FSH was 75 and Estradiol <15.  

The CT showed a 23mm adnexal cyst (possibly ovarian).  Symptoms listed were fatigue (severe), bloating, polyuria, and abdominal pain as if a period is coming.  (to name a few)  I also had breast tenderness for the first time in a long time.

I got a call that all is OK with the CT.  I am to see an endocrinologist about the hypercalcemia but am worried that nothing further is being done about the adnexal cyst.  My mother DID have ovarian, bladder and kidney cancer and ultimately died from brain metastisis.

Should/Could I request any further testing for this Ovarian? Cyst?  Could the hypercalcemia be related?

[Annekathryn Goodman, M.D.]

Hi There
all your symptoms are classic for hypercalcemia.
The pneumonic for hypercalcemia is :
bones , groans, emotional overtones

Ovarian cysts are common and that one is  tiny.
I would definately get a follow up scan perhaps a pelvic MRI

If a cause of hypercalcemia is not found, you should have that ovary removed.
There is an extremely rare cancer called a small cell cancer that produces hypercalcemia.
please let us know how you are doing
best wishes
ak

[Annekathryn Goodman, M.D.]

Hi There
I am not an endocrinologist but your calcium seems to be close to normal. I am not sure that a hundredth of a point higher than the normal range is significant. You should check with your endocrinologist about that.
It sounds like you have a small but persistent ovarian cyst. It has a very high likelihood of being benign. However if you continue with your symptoms of bloating and discomfort, that maybe a reason to see a gynecologist and have another  gyn exam and opinion
best wishes

[sophie50]

I had a followup ultrasound.  It showed:
1) Simple left ovarian cyst 1.1x0.5x0.8cm
2) 1.0x0.7x0.9cm left anterior body hypoechoic intramural fibroid

Additional ionized calcium came back high again 1.33 (1.17-1.32) with PTH 32.6 (15-65)

Should there be any additional followup?  At what point would I want to see a gynecologist?

Thank you!