Ovarian Mass Removal

[ms14]

I'm 25 years old and after an ultrasound I had due to having several late periods, I found out that I have a 4cm mass on my right ovary. It is non-vascular, but is both solid and fluid filled. It is being removed via laparotomy in 2 months. I live in Canada where wait times are fairly long. My gynacologist believes that it is not cancer, and I have no family history of cancer and am otherwise feeling fine.

My gynacologist said that an MRI would not provide extra information for this. Is this true? I have been referred for one, but it takes a long time in Canada. I want to know if the MRI can give more information, because if so, I will gladly pay $600 to have one done in Buffalo.

I would also like to get a better feel of recovery time for laparotomy. There is the possibility that my right ovary will be removed as well, though I hope not. I was told I should plan on taking 5 weeks off work. Is this realistic? I have an office job, I don't drive to work,  and am very fit.

I am stressed about the cause of this and the possible occurence on my left ovary since I want kids. However, I realize that until I have the surgery, the cause won't be known.

Thanks in advance

[Annekathryn Goodman, M.D.]

Hi There,
I agree with all the comments. I worry that adding an MRI will not change the plan and is quite expensive.  You should ask your doctor about a laparoscopy. Why is this not part of the plan? The recovery time is much shorter with the smaller incisons (2 weeks versus 6 weeks).  Ultimately, your doctor who has looked at the scans and done an exam and knows you is in the best position to judge what is the best surgery and the best surgical approach.
best wishes with your surgery.

[kristpin]

I don’t know any answer’s to your questions but I wanted to tell you that you’re not alone!  And try to keep positive!

[Neta100]

Hi there.  I am in the same position as you are and the oncologist told me the same thing.  Until doing a laparotomy and doing a biopsy they cannot know for sure if it is cancer.  The MRI will help to know if it has spread to other areas, but not if it is benign or not.  The period of recovery is for a month.  Many times these ovarian cysts are benign, specially in pre-menopausal women like you and I.  Like you, I don't have kids and I am concerned about the possibility of not being able to have kids.  But let's hope for the best.

[ms14]

Thanks for your answers. Seems like many people have similar problems, which is really unfortunate!

Apparently I can't have laparoscopy because the mass is too big. I have read that anything less than 10cm can be removed with laparoscopy, but when I asked my doctor about doing it that way he said it was too big...

[kristpin]

How big is it now?

[mousewhisperer]

I think it also depends on the skill level of your doc. My cousin had a tumor removed last year by laparoscopy and it was over 10cm. It can be done, but you definitely want a skilled surgeon that feels comfortable with what he is doing. Best of luck!

[ms14]

How can I find out if my doctor is skilled or not? It seems like this is out of my control. So many people are telling me I should be having laparoscopy, since it is only 4cm. Furthermore, he didn't even do an exam on me, just read me the radiologist's report. Then he also told me that my irregular periods had nothing to do with the mass and it was probably because I wasn't producing any eggs. Where does he get this stuff? When I read on the internet, ovarian masses clearly result in irregular periods. Should I look for a new doctor?

[kristpin]

100% absolutely!!!  You should feel comfortable and confident in your doctor.  You should feel like he has looked at all the possibilities based on your medical history & has based his decision on that.  You don’t want some cookie cutter diagnosis & surgery.  What if you don’t need it or he missed a detail that would be crucial to your diagnosis because he didn’t get all your history.

Anyway, I always get a second opinion when a doctor tells me I need surgery.  Just to feel confident

[Annekathryn Goodman, M.D.]

Again - alot of wisdom here.

I would suggest that it is important to see a health-care provider who does do a physical examination.
take care

[ms14]

Is the treatment that I am getting for my complex ovarian mass normal? I had the ultrasound on February 14th and the surgery is scheduled for May 22nd. I have not had a single ultrasound or test since and none are planned other than an MRI that I don't seem to be getting a call for. Should I be more pushy? My family doctor sent the requisition for the MRI again last week when I asked her to do so.

I was also referred to another gyn earlier this week by my family doctor, who would maybe do laparoscopy. However, wait times are so long to just get a call from the doctor, I might just be better off getting this thing out on May 22nd with the full incision. About half the time I feel normal, and the other time I feel pressure on my right side. My menstrual cycle is also very irregular and my last period was very painful.

It seems crazy to me that I would have surgery 13 weeks after an ultrasound without another test to verify that the mass is still there. What do you think?

Thanks.

[Neta100]

Hi there.  I also have to have surgery due to ovarian cysts on my left ovary and I'm scheduled to get operated.  My oncologist told me that it was better to do it as soon as possible in order to prevent it from getting worse.  I have no symptoms related to the ovarian cysts, like bloating, bleeding or abnormal periods, but in a transvaginal ultrasound they found the cysts had grown considerably, so they are doing a laparotomy and not a laparoscopy in order to get checked out completely.  I have talked to doctors and done research, and by what I have found out, if the cysts don't dissolve by themselves in a few months, it's better to get checked and do the surgery.  I know it's frightening, specially since you are young, but it's better have surgery sooner since nothing is known for sure until they do a biopsy of the ovarian mass.  Most of the times, in premenopausal women like you and I, it's probably something benign.  So let's hope out for the best and my best wishes for you.

Neta

[Annekathryn Goodman, M.D.]

Hi There,
it is tough to negotiate your particular health care system which I know has waiting lists for non emergency surgery.  a 4 cm complex mass in a 25 year old is most likely a dermoid cyst and will not change much before May. However, I understand your anxiety. If you do see the other gyn doctor, that would be a good time to discuss the need for earlier surgery. Also, 4 cm should be large enough to feel on physical exam and that doctor can confirm if it is still there. If it cannot be felt, that would be a good reason to repeat the ultrasound
best wishes

[SaraBum]

Hi There, I'm a 34 year old female and i just had surgery on my left ovary i lost it the ovary itself was 25cmx25cm please don't wait to have any test done the only thing that showed my ovary was a catscan and it was boarderline cancer thank god they got it out in time because my doctor never caught it!!..please have faith in yourself the doctors work for you not the other way around if you feel you need more test tell them!!! take care and i hope everyone gets the right treatment and god bless you!!

[SaraBum]

sorry my storie is a little long my doctor told me to lose weight!! and flip my mattress because i was having back trouble in the end they measured my belly and i was as big as a 11 month pregnant woman they had to go and remove it when it was found it had a hard mass in it so i had to wait 3 weeks to go see a cancer doctor well when i finally went to the E.R. it was 19cmx23cm when they actually took it out of me it was 25cmx25cm so please if you know something is wrong with your bodie please don't let it go!!!  

[ms14]

Hi Dr. Goodman,

I just wanted to update you on this issue of my ovarian mass removal. I had an MRI on April 9th and I found out yesterday at my pre-opt appointment that the mass had disappeared. The doctor was very surprised, since he didn't even think and MRI was necessary and would have done the surgery based on one ultrasound done in February. I can't believe that I almost had laparotomy for no reason. There were 2, 7mm fibroids found during my MRI, so I have another ultrasound in 2 months to check everything again.

All the best and thanks for your help through this.

[Annekathryn Goodman, M.D.]

Dear MS,
thank you so much for the update. I am glad that your cyst was most likely a cyst of ovulation ( a functional cyst). I would like to also thank all the other women who share their experiences here.
best wishes