Trans-V US Results

[Annie 64]

Just got results on follow-up US, left ovary contains an irregularly shaped cyst measuring 2.7 x 2.2 x 1.7cm. A few internal echoes are identified. No septations are noted. This has increased in size when compared to prior exam (7 wks. ago) No free fluid in the cul-de-sac. "Although this may still represent a hemorrhagic cyst, cystic ovarian neoplasm is of concern".

1.  What are internal echoes and what do they indicate?
2.  What is a hemorrhagic cyst? One that is bleeding? Or could?
3.  Would this explain why I have had several bad periods that
    keep getting brighter and brighter in color?
4.  When the tech was performing my US, I noticed that it
    appeared the area seemed to have texture like a raspberry.
    Is this indicative of any particular type of cyst?
5.  I am assuming that "no septations" and "no fluid" are good
    signs?

Any help or advice would be appreciated. I have been referred to a surgeon and would like to have some idea what will happen to me.

[MickeyVicki]

Internal echoes indicate solid components in the cyst.  A simple fluid-filled cyst does not have echoes.  Septations are like walls inside the cyst and can indicate an increased risk of malignancy.  A hemorrhagic cyst is, in most cases, a "normal cyst gone bad"; cysts normally develop and resolve quickly, but some not only fail to quickly resolve but also bleed, either into the cyst (making it larger) or outside the cyst (causing more fluid in the pelvic region.)  If you do have a hemorrhagic cyst and it is bleeding inside itself, then that would account for the increase in size.   Yes, no abnormal fluid in the pelvis is a good sign.  In fact, while it is scary and may result in surgery, the chances are good that you have a benign condition.

Your doctor will likely have a CA-125 bloodtest done to see if you have an elevated result which could indicate a greater probability of malignancy.  However, be forewarned the test can give false positives, and even a higher score does not mean cancer since many things influence the result of the test.  Also, if you have a family history of cancer, then please discuss this with your surgeon.

If you have read other posts on this forum, then you have read that the only way to determine whether a cyst or tumor is cancerous or benign is to have surgery.  How irritating, right?  As if we women did not have enough to do already!!!  Your surgeon might do a laparascopic surgery to remove the cyst.  If the cyst is benign and there is no damage to the ovary then the ovary will be left intact.

I had an ovary and a complex cyst with  solid components removed in December.  It was a benign endometrioma.  It nearly doubled in size in less than a month.

[Annie 64]

THANK YOU for the insight given. I appreciate your help greatly. I have actually had the CA-125 test performed, the result came back "inconclusive". Not positive, not negative, just inconclusive. The test, as I am sure you know is not cheap but my insurance company is. They would not cover a second test as they, in their great (#@%**@!) wisdom felt that it could come back with the same lack of results. I was informed that this type of result was unusual and my specimen had probably somehow gotten contaminated but that by repeating the test I was not guaranteed accurate results.

After reading several of the postings on the forum, it appears that you have certainly done your research on this issue. Not to be personal, but do you have a medical background? Or were you just thrust into becoming a very knowledgeable patient? I am not in the medical field, but after my parents health problems (stroke, seizure disorders, ALS, etc.) I have picked up an awful lot.

Once again, thank you. I will let you know how things turn out.

[MickeyVicki]

I have worked as a caregiver and I have learned so much from the hours, no - make that days!, that I have spent in the company of doctors and nurses, as well as cancer center and hospital staff.  I am so well-versed in oncology, cardiology, hematology, and endocrinology that some doctors have assumed that I am a doctor or nurse myself.  My own endometrioma was a new one for me, however, and I had to get an education on that one!  

I cannot print what I think about my insurance company these days!!!!