Differential diagnosis...so what now?

Two weeks ago, I had my right ovary removed by laparoscopic surgery due to the discovery of a complex cyst that had a "spot" on it. The surgery went well, and no other issues were found with my other ovary or my uterus. I received an initial pathology report back last week that states"

"The ovary shows multiple scattered benign follicle cysts in various stages of development. Some of the cysts are hemorrhagic...The serosal surface shows a few small fibrous adhesions with a small benign surface epithelial inclusion gland seen focally. In addition in slide 1 and 4 is a cyst that has a wall of fibrous tissue. The cyst has an epithelial lining that ranges from flattened to cuboidal to micropapilary."

"The features are those of a serous tumor measuring approximately 1 to 1.5 cm in greatest dimension. My differential diagnosis is between a serous cystadenoma and an atypically proliferating serous tumor (borderline tumor / tumor of low malignant potential) and the histopathological features of these two show some overlap...There is no evidence of invasive carcinoma."

The pathology was sent for a second opinion with the same result, telling me that there isn't a definitive diagnosis. I am wondering what my next steps will be. My OB/GYN is consulting with an oncologist and I meet with her tomorrow for a follow up. I am having trouble finding information on how this kind of diagnosis is handled. I fear making the wrong decision when it comes to my treatment.

Thanks so much,
DKC

[Annekathryn Goodman, M.D.]

Hi There
thank you for your complete information

so the worst this could be is a tiny borderline tumor. It has been completely removed and there is no need for further treatment.
Borderline tumors of the ovary are malignant tumors that are cured by surgical removal. They are slow growing. If the whole ovary had not been removed, there would have been a risk of this tumor returning (although even in that situation, surgical resection would have completely treated it)

However, with the very careful report - it is not even clear if it is a borderline tumor. For a benign and atypical proliferation nothing more is needed as well.

The one question is whether you may have a risk of developing a malignancy or benign tumor in your other ovary.
I would say at very least, you should get a yearly pelvic ultrasound
take care