Is Ovarian remant cause for surgery

I had a TAH in 2007 after a series of appts for right sided abdominal pain that was thoought to b due to my IBS. at my recent gyn appt i learned that on the right side an ovarian remanant has grown back, has two 3 cm cysts both hemorrhagic. one had ruptured with fluid in cul d sac. My gyn subsequently drew a FSH and CA125 both were elevated, so he recommends I go see a gyn onc to have remnant removed to rule out ovarian cancer. What are the chances that this can b cancerous? I have some reservations about having more surgery, I have had a total of 4 surgrys prior to tah for endo, firbroids, cysts, and adhesions and i am really afraid to undergo surgery again

[Annekathryn Goodman, M.D.]

Hi There,

The chance of cancer is low. However, an ovarian remnant syndrome can cause pain. It is worth meeting with the gyn oncologist just to get their opinion.

Also it would be important to get serial CA 125 levels to check for stability. Have you ever had a CA 125 before? if not, you do not know what your baseline is. With IBS and with any inflammation of the abdomen, the CA 125 protein level will be high. Other reasons for CA 125 elevation include endometriosis, and infection.


However if you have serial CA 125 levels and the level keep rising (for instance 30 then 45 then 100 then 200) that would be worrisome for a malignancy.

The FSH elevation could be because you do not have active ovarian tissue (which case it is unlikely that this is an ovarian remnant) but an estrogen level is probably helpful as well

please let us know what happens
best wishes