Complex Ovarian Cyst - too young for problems?

[27tooyoung]

I had an abnormal transvagianal ultrasound.  It showed I had an 8.6cm, 4.6cm, 4.7cm complex cyst on my right ovary with a nodule.  I have been reading through all of your posting and they are very helpful, but here is my question.  My gyn & the surgeon she sent me to said "Oh, you're 27, so there's nothing to worry about.  If you were say 50, then we'd be quite concerned."  That DIDN'T make me feel better.  From what I can tell due to the large size and that it is complex, it will not go away on it's own.  Am I being paranoid or will it go away on its own? (I am on the pill currently.) Does the nodule mean it could be cancerous??  What about my fertility??  I don't have kids yet!  Thanks for all of your help.

[llbgirl]

Hi there,

Thanks so much for your message. It feels great to know that we have each other in these tough times. The scar doesn't sound bad, but the recovery sounds brutal.  I'm glad that you came out of it okay. My surgery is booked for December 13...I already have four weeks off work.

I had a CA-125 blood test done. My levels weren't even elevated...everything was normal.  

I saw my gynecological surgeon and my general surgeon a couple of days ago and - wonder of wonders - they both think that they can remove both cysts and my gallbladder through laproscopic procedures (one for the cysts and one for the gallbladder).  The gyne surgeon also said that he's going to save my ovaries - both of them!  I have a tough time believing that so I'm getting ready to lose them, but it would be amazing if things ended up not being as bad as I had thought.

I have a contrast CT scan coming up to determine what the heck is sitting on my liver. The results of that scan will likely determine further courses of action.

What do you think about my doctors' decisions? Do you think they're being a bit too optimistic?  (BTW, the right cyst is 12x7x6 cm, and the left one is 6x3x2).  

Talk to you soon - I'm glad you're doing well.

[pianist]

What kind of test did you do for ovarian cancer?  Just wondering....

[pianist]

Hello,

I just went through this a few weeks ago.  Here're my answers to your questions:

The scar is a vertical midline incision, which means from just below your belly button to the bikini line.  If the tumors are clean, it will take about 2-3 hours.  It really depends on individual situation.   As for my experience, the pain after the surgury is nothing close to the pain before the surgery.  It also depends on your health condition and age.  I remembered I kept asking the nurse when the servere pain will kick in 18-24 hours after the surgury.  Obviously I was not in much pain.  Discomfort is a definite, but you will feel much better, at least physically.  

Important reminder:  Your doctor will tell you not to go to work for at least 3-4 weeks, and complete recovery takes at least 6-8 weeks.  Take his/her words seriously.  If you're not patient, you will be pay the pain back later, both in short term and long term aspects.  I felt pretty good after a few days so I got up a lot (you're supposed to stay in bed and literally lie down a lot) working at home and practicing the piano.   Eventually my incision didn't heal too well (plus minor infection) and I started to have a lot of internal pain and back pain.  So, be sure to take it easy!  You also should get up and walk slowly for 5-10 minutes, a few times a day.  You doctor will tell you how much you should do it.  After the surgury, your lungs will be much weaker, so if possibile, you should get some fresh air and strengthen your long.  The doctor will give you a little device to do it.  What else...  Eat well (protein stuff) and avoid gassy food, since you'll feel pretty bloating and gassy after the surgery.  Drink a lot of water - as you will be taking some heavy-duty medicine.

I think both of your ovaries will be removed as the tumors probably have already destroyed the ovaries, giving the size of an ovary is like an almond.  I'm really sorry to tell you that but I think that will be the case - of course you should wait to see what the doctor says.

One last important note - I forgot if yours are simple cysts or complex cysts.  But anyway, most of the complex cysts are beneign, only 2 % are maglinant.  You should ask your gyn about the possibility.  They might tell you it's unlikely to be maglinant since you're young and the % is so small.  My advice is to demand an answer of what if....  Don't take any chances...
My experience was I didn't know anything before the surgury since it was an emergency one and I was very drugged out with morphin.  (I went to the ER and had to have the surgery the next day)  Cut the story short is they were so confident that my tumor was beneign, so they didn't check carefully and take some sample to do biopsy in the OR.  Eventually, the pathology report showed that it was maglinant and they are going to cut me up through the same incision again 5 weeks after the first surgery to take more sample.  I don't mean to scare you, but I think you have the time to ask more questions and do more research before the surgery.  I'll be thinking of you and good luck!  Stay positve and it will definitely help in coping with the pain!
If possible, don't start working earlier than you have to, your family and friends will be more than happy to give you a hand!

[llbgirl]

Hi everyone,

I had to respond, because I'm also 27 years old and I'm dealing with a lot of the same concerns as you ladies.

I was diagnosed with Polycystic Ovarian Syndrome when I was 13. I went to the hospital one morning about 2 weeks ago after getting constant abdominal pain that lasted over 11 hours. After getting an abdominal & pelvic ultrasound, I found out that I have two large complex cysts (one is 12x7 cm, and the other is 7x5 cm). The big one is on my right ovary and there's some evidence of torsion. The smaller one is on my left ovary. To make matters worse, I also have gallstones and an as-yet undiagnosed "mass" on my liver (all they know is that it isn't a fatty deposit).

I was tested for ovarian cancer and thank God, it came back clear.

I'm going to see an OB-GYN this week to discuss surgery. I'm pretty sure I'm going to have to do open surgery as well - laproscopy isn't going to cut it (pardon the pun) for cysts of this size, especially the one on the right. While I'm dealing with the ovarian cysts, we're going to get the gallbladder out in the same surgical procedure. One stop shopping!

I'm still getting pretty constant upper abdominal pain and pain in the right side of the middle of my back.  Sometimes it starts in the abdomen, sometimes it starts in the back.

I have to admit, I'm terrified. I'm especially scared of losing my ovary or ovaries. I'm also worried about the dreaded scar and of losing my job over the extended medical leave.

Can somebody please shed some light on:
- how big the scar is;
- how long the surgery lasts;
- how painful the recovery is; and
- how long it'll be before I can return to work (I'm a lawyer, so my work is primarily desk-bound with the occasional trip to court)

Thanks so much ladies. It's nice not to feel so alone. I'll be checking for your responses. Bye!

[27tooyoung]

Again, thank you all so much.  I knew I didn't feel comfortable with "you're only 27."  

I've taken your advice and have an appointment tomorrow with a gyn/onc just to get another perspective.  I'll keep you posted.

[pianist]

Hi, I was in the ER a month ago because of severe pelvic pain and had an emergency operation the next day on my birthday (I'm 33 years old).  After the CT scan, they found a 18cm x 15 cm x 8 cm ovarian mass!!!  Everything went well except the pathology report showed that it was a immature tetratoma (cancerous).  So, now I have to go through another staging surgery in the same vertical incision.  It really freaked me out to have another operation in such a short time.  Since 98 % of the tetratoma is beneign, the doctor assumed that it was not cancerous.  My point is the doctor should not assume nothing will happen even though I'm relatively young for ovarian cancer, and he should not assume it is absolutely beneign.  After talking to another specialist, he told me that another doctor should have done the biopsy in the OR so that they can do staging procedure at the same time.   Another thing I've learned is to always trust your instinct, we know our body the best.  If you have doubt, you should always get a second opinion.  I went to my family doctor two weeks before the surgery for the severe pain, he didn't think it's such a big deal as he couldn't detect there was such a big mass in my abd.  (I'm 5 ft 4 and 140 pounds, so I'm not overweight!)  Stay strong everyone!

[pianist]

Great!  Of course I'm hoping the very best for you, but just in case, then I don't want you to go through twice like me!  It's a very common negligence in this case.  Don't rely on the statistic too much and you have to be proactive.  Good luck!

[MickeyVicki]

Smaller cysts rupture frequently.  Larger cysts can rupture as well; I do not know if this problem is common, however.   The most common symptom of a ruptured cyst is acute pain - pain that is severe and localized.

[27tooyoung]

Thank you all for your comments.  You have made me feel better, and I have scheduled an appointment for another opinion.  MickeyVicki, I hadn't even thought about the possibility of it rupturing.  Do you know if this is common?  

Xrayu2, please keep me posted on your debris situation.  I will keep you all posted and thanks again!!

[Pammy9]

I'm not sure I agree or like the way your doctor stated about your age and not worrying.  Whatever the age IF you have cysts or nodules, I think they should be taken as if you were any older or younger for that matter.  I'm 34 and have 3 go arounds with cysts so far in the past year and a half.  I hope you are scheduled for a follow up with someone else - if not, I'd consider calling someone else.

[MickeyVicki]

No, it is not likely to resolve on its own.  Worse still, should such a large cyst rupture and spill its contents into your abdomen, then an infection might result.

Assuming that you have at least one healthy ovary, then you should still be able to have children.  The loss of an ovary only reduces the chance of having children by some 15 to 20 percent, and that statistic is without fertility assistance.

[xrayu2]

I am 30 and have bilteral complex ovarian cysts.  My left ovary was cystic and had a "piece of debris" in it in August.  We repeated it in Oct, the piece had grown to "1cm solid mass with papillary projections"  and  my right ovarian cyst doubled in size and filled with debris.  My gyn said "your 30"  its probably ovulatory.  He wanted to watch it two more months.  I see a gyn/oncologist on Monday-my gyn referred me to him after looking at the u/s himself.  While most cysts are benign and are due  to ovulatory changes or endometriosis, no one should suggest that age has anything to do with wether or not a problem could be malignancy.  I do not know yet what I have going on but I was not resolved on the fact to let it wait.