Large complex adnexal mass

I recently had a CT .scan of the pelvis with contrast to check for swollen lymph nodes as I have swollen lymph nodes in my neck and axillary.  The report states "7 x 6 x 4 cm fluid density mass in the left side of the pelvis which appears to be at ovarian in origin and contains some internal septations.  The are 2 smaller fluid density rounded lesions right adnexa measuring under 2 cm each compatilble with prominent follicles.  Tiny amount of free pelvic fluid in the posterior cul-de-sac.  Impression: Large complex cystic left adnexal mass".  I am 45 years of age - my symptoms are mainly pain in lower left abdomen, bowel changes, frequent urination, fatigue and nasueas.  Would you be so kind as to tell me with this limited information, if you think this is ovarian cancer?  What do you think the most likely outcome would be - just a cyst or ovarian cancer?  I would appreciate your opinion very much.  Also, should I see my regular gyn. or a gyn. oncologist?  Do you think this mass should be removed?  I weigh 102 lbs, and am 5'4.

[Annekathryn Goodman, M.D.]

Dear Helen,
It is not possible to give a diagnosis of ovaran cancer. Currently your diagnosis is "pelvic mass'.  From the Ct scan, the mass could be an ovary, a fallopian tube, a growth off the uterus, bladder or bowel.  It could be a benign tumor, an abscess, or a malignant tumor.

The next step is to have this mass removed. I would reccomend a gyn oncologist - not because I think it is malignant but because gyn oncologists have alot more surgical experience than general gynecologists. If this pelvic mass turns out to be malignant, the gyn oncologist can effectively manage the situation and not have to call anyone else in or send you for a second surgery.
please let us know what happens
best wishes