Complex cyst and free pelvic fluid

I am so thankful for this forum! I have 2 complex cysts: one in each ovary, measuring 4.2 cm and 4.1 cm, and there is free pelvic fluid in the posterior cul-de-sac.

The doctor said these could be enlarged corpus luteum cysts, but that he can't be certain (especially because of their size and because there are two of them -- corpus luteums are typically solo cysts), so I am scheduled to have a 2nd ultrasound in 1 week from now (the 1st ultrasound was 2 months ago).

My questions are:

* What is the significance of finding free pelvic fluid? What does it mean, and why do doctors make a note of this finding?

* Is it common to have cysts on both ovaries?

* What are the chances this could be cancer?

Thanks so much!

Holly

[Annekathryn Goodman, M.D.]

Hi Holly,
Cysts can mean many things. Between the ages of 13 and 50 years, it is the normal job description of the ovary to make cysts. A cyst means some fluid enclosed in a thin skin or membrane. Think of it visually as a blister. There is a cyst that the egg matures in, then after ovulation, there is a cyst that makes progesterone. The second kind of cyst is called a corpus luteum.
The first kind of cyst is called a follicular cyst. The best way to know if ovarian cysts are of this sort (called functional or physiologic cysts because they provide a normal function), is to repeat the ultrasound after a menstrual period.

Free fluid usually occurs if a cyst ruptures (such as ovulation)or leaks. That happens at midcycle and can hurt. Sometimes the fluid is blood as the cyst can bleed when it ruptures.

If there is alot of fluid and the cysts are not going away, one does worry about a tumor (benign and maligant) that can produce fluid (which is called ascites).

It is unusual for functional cysts to be present on both ovaries at the same time but it is not impossible. Other kinds of cysts such as endometriosis, nonfunctional benign cysts, fluid in adhesions or in the fallopian tubes can occur.

The chance of a cyst being cancer will depend on a person's age, whether the cyst is persistent, family history of cancer, size and complexity of the cyst.
Your doctor's decision to repeat the ultrasound is the right first step
best wishes

[happyholly]

Thank you!

[lmartin]

Hi!
I was wondering if you could help me with a troublesome finding, or am I over reacting?
Feb. 24th of this year I under went adominal (abdominal) exploritory surgery which left me w/ abt. a 9in. incesion. Findings were that I had a hemoratic ovary.
Since surgery I have developed the following sytoms, and over time has became worse:
- Blooating
- severe adominal (abdominal) tenderness
- excessive gas
- Nausea
- Constipation
- Diareaha ( after being bloated and constipated for a # of  days)
Two weeks ago I was admitted into the E.R. again w/ the above sytoms. The Dr. ordered a C.T. Scan and after what he called abnormal fondings then ordered a Transvaginal Ultrasound.
Findings: Transabdoninal and endovaginal images were performed of the pelvis. The Uterus has a normal appearance measuring 9.2 x 4.7 x 5.3 cm. The endometrial strip is thin and measures 9 mm. Within the right adnexa, there is a complex, solid appearing mass measuring at least 5.6 x 6.9 x 6.1 cm. This extends into the cul-de-sac. There is free fludid. Flow is seen within this right adnexal mass. A normal right ovary cannot be identified. The left ovary has normal appearance measuring 2.7 x 2.0 x 2.7 cm. Note is made of a probale left corpus luteum cyst.
Impression: Complex solid right adnexal mass. Differential dianosis includes neoplasm. Differential dianosis would also include ectopic pregancy with clot, tuboovarian abscess, or endometriomas. The appearance favors neoplasm over the other enities. The left ovary has a normal appearance.
I was the referred to a Gyn. w/ told me this is a  normal cyst and would go away on it's own, and to come back in six weeks for another ultrasound. She then referred me to a Gastrologist who is in question abt. her response to this test. He also believes that this what he called a mass not cyst is possibly putting preasure on my colon causing my severe bowel problems. He has ordered a Barieum Enamea X-Ray the later part of next week.
I am troubled by this because the Dr. @ the E.R. that ordered this Ultrsound said that I have a massive tumor, not cyst because cyst don't have blood flow also. Please tell me am what should I do?

[akg]

Hi There,
It sounds like you have had a hard year. It could be that you have some adhesions from your February surgery that have contributed to your present symptoms. The cyst/ mass on your ovary could be another hemorrhagic cyst - they can look very complicated. As you did not have a tumor on your ovary 9 months ago, it is more likely that you have another hemorrhagic cyst. However, it is not impossible for you to develop something new. Therefore checking again after a menstrual cycle to see if the ovarian mass/ cyst is gone is reasonable. Having a GI work up is reasonable as well.
take care.

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