Recurrent Borderline Mucinous Ovarian Tumor Presentation

Hi. Thank you for taking the time to answer my questions.

I had my left ovary, tube, and borderline mucinous ovarian tumor removed 4 years ago. I have been very compliant w/ 3 month follow ups and routine CA125 tests. I recently complained of decreased bladder control and bloating, which prompted an ultrasound. The radiologist stated that: there is a mass within the left ovary, measuring 3.6cm x 3.0cm. The lesion is a solid tumor w/ echogenic rim identified. The appearance is non-specific for any benign or malignant ovarian tumor.  The original path report diagnosed proliferating mucinous tumor (mucinous borderline tumor), endocervical type, low grade, no identifiable invasion. My last CA125 test was 3, and that was two weeks ago.  Upon further imaging to test for infertility three years ago, the left fallopian tube was present. I have since had a child and have been recently trying to get pregnant but am still lactating.

What is the likelihood that the left ovary "grew back" from a remnant and now has a tumor? Do you have any differential diagnoses, based on experience (CT scan is pending). Do borderline mucinous ovarian tumors typically present in this manner the second time? My original path report stated that my ovary that was removed had a hemorrhagic corpus luteum cyst partially adherent to the cystic mass. Is there any possible correlation between a hemorrhagic cyst and  the ovarian tumor, since it has been suggested that the "new" left ovary has a possible hemorrhagic cyst? I have had uterine fibroids for a while. Is it possible for one to present in this manner?

Many thanks!
Heather

[Annekathryn Goodman, M.D.]

Hi there
you ask very good questions
it is possible to have an ovarian remnant syndrome it could be benign, borderline, or malignant.

One option is to try to suppress ovarian function with lupron and see if it gets smaller.
if it does get smaller, it is not a tumor but rather functioning ovarian tissue.

if it does not get smaller with lupron over a 3 month period, you should consider surgical removal.

You should ask your doctor about these options
best wishes