Ovarian tumor

Went to gyn last week for evaluation regarding abnormal mentral bleeding. Transvaginal ultrasound revealed a 4cm tumor on my rt ovary. Was told it was solid (not cystic). Also did a uterine biopsy which came back normal. CA 125 results were normal, as was blood count. My doctor said that I have 2 options. I could have laproscopic removal of the ovary with or w/o a vaginal hysterectomy, or I could have abdominal surgery to remove the ovary and/or uterus. The left ovary would be left alone unless it was cancerous.   I am unsure what to do. Should I have further evaluation through testing or a second opinoin. Should I have the surgery done by a gynecological oncologist just in case?  What are the pros and cons to the hysterectomy?  Is there a sure fire way to determine if it is cancer without surgery?

[Annekathryn Goodman, M.D.]

Hi There
it sounds like you have been given a reasonable set of choices. Completely solid tumors  are rarely malignant. Usually there are benign tumors such a fibroma. There are some very slow growing malignant tumors that are cured by removing them that produce hormones (estrogen, testosterone) and can cause abnormal bleeding.

The decision to just remove the ovary versus the ovary and uterus may depend on if you have any other issues such as a family history of cancer, a personal history of cancer, a personal history of abnormal pap smears, a history of prolapse, pain, fibroids etc.
All those things are part of the decision.
If you have no other medical history, the smallest intervention would be removing the right ovary and tube and doing a D&C (dilation and curettage) to check to lining of the uterus even more thoroughly.

You should ask your doctor about whether you have other risk factors or problems (as listed above) that would make a larger surgery make sense
take care