Dermoid Cyst

I a 48 years old and have been getting periods only about every 3 or 4 months. When I mentioned this to my primary, she orderd an ultrasound. The results of the ultrsound report was a mass on the left ovary, possibly dermoid, and a recommendation for a MRI. The MRI  confirmed a dermoid cyst, but my primary said that I could proablly leave it alone, because I had a Cat Scan done 5 years ago and the cyst had shown up on the Cat Scan, and had not changed at all in that time. I am not experiencing any real pain, other than an ocasional achy feeling in my lower abdomen, but I recently started feeling really bad pain in  my lower back and leggs, when I am either walking or standing for a long lenght of time. My question is, should I have this cyst removed, or is it safe to just leave it alone?. IThe most puzzling of all is that when I went to the ER five years ago because I was feeling pain and pressure in my abdomen and  upper thighs, i was given a Cat Scan of my pelvis and told that everything was okay. I was never told anything about  cyst. My primary only found out because I had the MRI at the same hospital as the Cat Scan, and she was sent a copy of both tests to use for comparrison. I'm really nervous about having this cyst left to grow inside of me. I'm not aware of any ovarian cancer in my family history, but my Mom was diagnosed last year with colon cancer. Do youthink that the cyst could be the cause of my abnormal periods, or am I proably going thru menopause?.  The only symptom that I have for menopause is the missing period, but I'm sure that at 48, it's most likley begining.    

[Annekathryn Goodman, M.D.]

Hi there
first of all your story reminds me about why I always urge everyone to get a copy of all reports for their own records.

Now having said that, it is fortunate that you have a scan that confirms that this cyst has not changed in 5 years. That petty much assures us that the cyst is benign. Depending on the size of the cyst, You should consider removing it if it is greater than 4 cm. . If greater than 4 cm, there is a risk of twidting (torsion) and pain.

As far as your periods, you should ask what the size of the endometrial stripe was. If greater than 6 mm, you need a biopsy of the lining.

Two other things to consider:
hormone blood tests to see if you are in menopause (estrogen, LH, and FSh)
also a progesterone challenge test: take progesterone for 10 days (such as provera 10 mg) and then see if you bleed. If you do, you need a biopsy.

finally you need a colonoscopy now with your mother;s history



best wishes

[carmy757]

Thank You for your quick response. As it turns out, My primary called me yesterday, before I even had the chance to check your response, and told me that she was setting me up to have an edometrial biopsy.

Thank you so much