Aa
Aa
A
A
A
Close
Avatar universal

Help with reports Ovarian Cyst, Confused.

I am 44 years old (no history of ovarian cancer in family, paternal grandmother had breast cancer) and went for my annual Gyn exam on June 16.  At that time the Dr. felt a movable cyst on my left ovary.  

TVUS report:

Imp: 3.8cm cystic mass in the left adnexa, possibly representing a hemorrhagic cyst.  Technical imp. did include complex endometrioma

2 mos later TVUS & CT:

CT found nothing out of the ordinary except the cyst.

TVUS:  There is a 3.8 x 3.8 x 3cm mildly heterogeneous solid appearing mass identified.  Though there is a small associated cystic area measuring approx 1cm in size the bulk of the mass is solid and a few echogenic foci suggestive of calcifications within the mass are noted.  Given the appearance this solid mass is suspicious and neoplasia cannot be excluded.  No FF.

Gyn Dr. looked at these films and totally disagreed with radiologist.  Sent for MRI

Impression:  3.9cm x 3.5cm, well circumscribed left adnexal lesion with increased T1, heterogeneous T2 signal, and no loss of signal on fat suppressed images.  This is most suggestive of an endometrioma or less likely a hemorrhagic cyst.  Short term follow up is recommended.  Post contrast images demonstrate enhancement of the cervix and myometrium, but the signal within the left adnexal mass is not significantly changed.  These findings are most consistent with an endometrioma, given the high T1 signal, which is suggestive of blood products.  Also, there is a small amount of FF within the pelvis.

No mention of calcifications on the MRI report.

Second opinion agreed with 1st Dr.  Repeat TVUS 8 weeks.  Extremely rare that this is anything other than benign.

I have no pain and had no idea that a cyst was there until the Dr. told me.  

Do you think that I am following the right course of action?  Also, do these cysts normally move around to the point that it is felt once and then on 2 subsequent occasions it can’t be felt?  

Thank you very much for your time
3 Responses
Sort by: Helpful Oldest Newest
242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi There
it is natural to fret.
It sounds like it would be fine to let your gyn do the surgery.
please let us know what happens
best wishes
Helpful - 0
Avatar universal
Hi,

Thank you so much for answering my question!

I am having surgery if it is not gone (or significantly smaller) by the next TVUS.  I keep obsessing over this, no matter how many times the Gyn Drs. tell me that it would be extremely, extremely rare that this is anything other than benign.  Throw in the (somewhat) controversy between the Dr and the ultrasound radiologist and I am a nervous wreck.

Are MRIs more accurate at diagnosing endometriomas than TVUS and CT?

Finally, based on the test findings do you think I should I feel comfortable with letting my Gyn Dr. do the surgery or should I see a Gyn/Onc for safety?

Thank you, so much, again for all of your help.
Helpful - 0
242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi There
thank you so much for your complete information.
To summarize, you have an asymptomatic mass that has persisted over 3 months. The best imaging study for characterizing the mass is an MRI. This suggests that the cyst is an endometrioma. Over this short follow time, the mass has not grown.

You have two options: close checks with exam and ultrasound and if it does not change, leave it alone or surgical removal .

You have to decide which approach works best for you.
The advantage of surgical removal is that you are then done.  If you add up the time and costs of coming in for follow up US or MRI (every 3 to 6 months) over many years versus a one time day surgery with laparoscopy and removal of that cyst or ovary, it is probably cheaper and less aggravating on your well being to just remove it.

On the other hand, surgery has a small but finite risk of complications.

Since this looks benign, you have time to think this through with your doctor,
best wishes
Helpful - 0

You are reading content posted in the Ovarian Cancer Forum

Popular Resources
Learn how to spot the warning signs of this “silent killer.”
Diet and digestion have more to do with cancer prevention than you may realize
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.