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Questions re: Differential diagnosis; of Hemorrhagic Ovarian Cyst v. CA
I am 43 & s/p hyster & Rt oopherectomy approx. 1 1/2 yrs ago for resection of severe endometriosis, w/multiple Lrg. endometriomas and atypical spotting between periods. Before surgery I had bloating, diff. w/uriniation & bowel movements, emisis, back & leg pain. All sx improved after surgery. The doctor left the Left ovary in because it was fxnal and I didn't want to take hormones if possible.
The symptoms began to return within about 3 or 4 months s/p surgery & have gradually increased again since then. I have had 3 follow up ultrasounds. The 1st showed a 3 cm endometrioma growing on the left ovary. The 2nd, approx. 6 or 7 months ago showed this to be slightly smaller. The 3rd, done about a month ago, showed an evidently large hemorrhagic cyst.
My aunt on my mother's side was diagnosed as having the "cancer gene" & is considered high risk for developing reprod. CA at some point. I have read that hemorrhagic cysts, while common, are worrisome because they cannot be conclusively differentiated from ovarian cancers via ultrasound alone. I was also diagnosed w/stage 4 sarcoidosis. Perhaps they are less worried as some research indicates the elevated vitamin D levels in sarcoid patients may help prevent CA. However I have never had any documented elevations of my vitamin D or calcium levels & I have had unilateral v. the typical bilateral hilar lymphadenopathy. Mediastinal biopsy was negative for lymphoma but I have since read that there is an error rate of up to 13% on this type of biopsy.
How concerned should I be about possible ovarian cancer?
The symptoms began to return within about 3 or 4 months s/p surgery & have gradually increased again since then. I have had 3 follow up ultrasounds. The 1st showed a 3 cm endometrioma growing on the left ovary. The 2nd, approx. 6 or 7 months ago showed this to be slightly smaller. The 3rd, done about a month ago, showed an evidently large hemorrhagic cyst.
My aunt on my mother's side was diagnosed as having the "cancer gene" & is considered high risk for developing reprod. CA at some point. I have read that hemorrhagic cysts, while common, are worrisome because they cannot be conclusively differentiated from ovarian cancers via ultrasound alone. I was also diagnosed w/stage 4 sarcoidosis. Perhaps they are less worried as some research indicates the elevated vitamin D levels in sarcoid patients may help prevent CA. However I have never had any documented elevations of my vitamin D or calcium levels & I have had unilateral v. the typical bilateral hilar lymphadenopathy. Mediastinal biopsy was negative for lymphoma but I have since read that there is an error rate of up to 13% on this type of biopsy.
How concerned should I be about possible ovarian cancer?
What type of dr are you seeing? A gyn/oncologist would be the best for the ovarian cysts.
If your drs are too slow for you or you don't trust them (and it sounds like you don't), ask for a 2nd opinion from another dr. You have the right to be partnered with a doctor you have confidence in. One woman here went to her 4th dr before someone figured out what was going on with her!
If your drs are too slow for you or you don't trust them (and it sounds like you don't), ask for a 2nd opinion from another dr. You have the right to be partnered with a doctor you have confidence in. One woman here went to her 4th dr before someone figured out what was going on with her!
Thank you for responding to my post. Honestly its just nice to have SOMEONE respond. I have had such a long battle with the doctors etc. through diagnosis of Lupus, Sarcoidosis, polycystic ovary disease and extensive endometriosis, as well as some other problems. I'm 43 and I already have osteopenia. My lungs have large nodules from the sarcoidosis throughout, and my lymph nodes are enlarged, primarily unilaterally. They did a bronchoscopy but the washings came back negative and did a mediastinoscopy for biopsy of my lymph nodes and it came back negative as well. But the problem is that they took the washings on the bronch from my right lung and the lymph biopsy from my mediastinal lymph nodes when the enlarged lymph nodes are on the left and its my left lung that has the largest and worst nodules. So now I'm worried that they sampled in places that could not have told them anything and diagnosed me with sarcoidosis by default. I mean...what if I have lymphoma and they just took the biopsy from a lymph node it had not spread to yet? Usually hilar lymph nodes are swollen BILATERALLY in sarcoid patients and I only had swelling on the left side.
Now...with this new hemorrhagic cyst on my left ovary, and my doctors reluctance to do anything about it, I'm worried something more is going on. My instincts have been screaming at me and I just don't know what to do at this point about getting someone to listen...or even what to ask them for as a next step really. Anyone have any advice?
Now...with this new hemorrhagic cyst on my left ovary, and my doctors reluctance to do anything about it, I'm worried something more is going on. My instincts have been screaming at me and I just don't know what to do at this point about getting someone to listen...or even what to ask them for as a next step really. Anyone have any advice?
I don't know all the terminology in your post or what sarcoidosis is. However, the "reproductive cancer" gene your aunt has is probably BRCA1 or BRCA1. IF YOU have that gene your risk of getting ovarian cancer over your lifetime can be as high as 45%. Compare this to the general population with a lifetime risk of 1.8%. Removing both ovaries lowers your risk, they're not sure exactly how much but one large study suggests you reduce your chances of ovca by 97% if they are both removed.
A hemmoraghic cyst just means the cyst is bleeding into itself, but you are right, it is harder to tell a hemo cyst from a cancerous one on an ultrasound.
The Gilda Radnor Familial Ovarian Cancer Registry has good info on the genetic links to ovarian cancer. They are at:
www.ovariancancer.com
Hope this is helpful!
A hemmoraghic cyst just means the cyst is bleeding into itself, but you are right, it is harder to tell a hemo cyst from a cancerous one on an ultrasound.
The Gilda Radnor Familial Ovarian Cancer Registry has good info on the genetic links to ovarian cancer. They are at:
www.ovariancancer.com
Hope this is helpful!
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