Possible ovarian cancer with bone met's?

[peipaws]

"I'll try and keep it brief but give you as much detail as possible.

A yr ago my gyn drained a fluid filled cyst.  Pathology came back on this fluid .....small atypical papillary clusters of cells are identified some of which have a central psammoma body. In comments also has ....a few small atypical papillary clusters, one having central calcification/psammoma bodies, and although these may represent a benign lesion, a more worisome process cannot be excluded.  Had the LSO along with a pelvic washing and ovary tested benign.  

Haven't been feeling well lately and went to dr for gastro issues, pain in ribs, heartburn, which i never have, back pain/achey thighs and just tired and constant BLOATING.  Dr ordered a ultrasound and mri.  Ultrasound of abdomin ruled out gall bladder.  Mri found 2 complex cyst 1.6cm and 1.7 cm to form one complex right ovarian cyst.  Additionally a small amount of free fluid.  Also states....ill defined sclerotic lesion left iliac bone with additional areas of sclerosis throughout the osseous structures.  Differential includes benign bone islands, however given the ill-definition, sclerotic metastases cannot be excluded.  Clinical correlation as to history of primary malignancy and well as correlation with a bone scan is recommended.  It states the lesion measures 1.1 cm and scattered throughout the osseous structures are additional smaller areas of sclerosis.I am scheduled for a bone scan and also pelvic sonogram.  Gyn out of the office but have my appt on Dec 22.  If ovarian cancer could it met's so quickly.  A yr ago ovary was fine.

[akg]

Hi There,
Thank you for the additional history. I think you are on the right track. With previous benign findings, that is very reassuring. However, if there is any question about this - that is the cyst is changing or you are having pain - I would recommend that the ovary be removed.
best wishes to you

[peipaws]

I'm 41 yrs old.  Had my hyster 3 yrs ago due to mutiple fibroids.  My left ovary did test benign when they removed it a yr ago.  The psammoma bodies originally were found in the cyst fluid that was drained from the cyst durring the scar tissue removal.  My gyn did the surgery but he had a gyn/onc he was consulting with and on stand by if he did need him for the surgery.  A pelivic washing was done also when the abdominal LSO was performed a 2 weeks later.  Since ovarian cancer was a possibility a year ago they are focussing on it now.  The first cyst was a simple, fluid filled one.  These are "complex cystic lesions".  I do have my bone scan Thurs so hopefully that will clear up the possibility of a metastases from a primary.  

Since psammoma bodies have already been found once, should I be more concerned?  If this turns out to be nothing should I consider getting my last ovary removed.  I really dont want to go thru surgical menopause but if that is what is best, I will.

Thank you for your help.

[Annekathryn Goodman, M.D.]

Hi There,
It sounds like you do not have a primary diagnosis of ovarian cancer. You had a benign ovarian cyst that had psammoma bodies within it. Is that right?
Now you have small cysts on the other ovary. How old are you? Are you having your periods? When in your menstrual cycle was the ultrasound performed?

The bone film has a scary report. Usually this turns out to be a benign bone island. Remember the radiologist does not know your story. Context is everything with radiology. That is why there is such a long list of possibilities to explain the xray finding. However, you are getting the correct follow up testing.

Please let us know what the follow up is on your x rays.
best wishes to you

[peipaws]

I wanted to add that I had a LSH in 04 and that the previous cyst that was drained gave me no problems and didn't even know it was there.  Went to dr for pelvic pain on the right that durring Lap surgery was found to be scar tissue and he removed it.  He drained the cyst that was being watched when he removed the scar tissue.  It DID NOT look suspicious or he would of removed the ovary at that time.  It was removed 2 weeks later after pathology came back.  My ca125 was 6 then and 3 weeks ago it was still just 8.6