Unchanging small solid mass - should I get this operated?

I am 35 years old with a history of infertility - have gone through 3 IVF's after Chlomid. On having unexplained abdominal pain (upper quadrant), I urged my OB-GYN to also do a Trans-vaginal ultrasound and they found a small (2 cm) solid cyst on my right ovary. This was in July. We followed with another U/S in Sept when the cyst was still there and so we did a MRI. MRI didn't show any malignancy and the CA 125 came back at 8. Went to a GYN Oncologist and she suggested a follow up again in 3 months. Just completed the U/S and the cyst still exists - looks solid and is at 1.8 cm. Repeat CA 125 came back at 9. Dr. suggests we can either continue following this or can take it out if it is making me anxious. In the mean time the upper quadrant pain was gone for the past couple of months but I have started feeling it again. I also have a tugging pelvic pull at times and also some pelvic pain even after the periods are over. Dr. seems to think this could be an endometrioma.
My question is how long can we follow this? Should we just take it out? Will the ovary be taken out as well (Dr. says yes).  
If the CA 125 is normal and the MRI does not show malignancy, what is the probability that this is OVCa? Is the abdominal pain in your opinion related to this or could it be something else? My concern is we are doing a relatively non-aggressive lets wait and see approach and may be it is actually cancer that is spreading inside? How probable is that in your opinion with the information I have given above?
Your response will be greatly appreciated.

[junamgen]

Just remember that final dx of OVCA is from biopsy not ca125 or MRI. I would have it out if I were you. Just have a worry free mind for a long long time.
peace

Jun

[vidflorida]

I am interested to hear other opinions on this. My oncologist does not want to take my 'mystery cyst' out. It is 2.9 in size and has been around for over a year now. My CA 125 levels came back at 54 now they are 41.  He said not to worry, his gut tells him it is not cancer.  He indicated if it was cancer by levels should continually rise and not go up and down.  He thinks endometriosis is on my ovary.He also said I could pursue fertility help since I do want another baby and have not been able to get pregnant for over two year.  My other ovary has diminished ovarian reserve...so I struggle with whether to have laparoscopic surgery or wait and see.  I am tired of waiting and seeing - to be honest!

[amazing1672]

Hi there,

Do you have any symptoms - any pain, bloating etc. I am with you when you say you are tired of waiting and seeing. I am in the same boat and am really leaning towards a lap to take this out. I just don't want to go from the frying pan to the fire where today taking this out seems like a good option but, I don't know what will happen if I take the ovary out as finally this is a surgery and has its own issues. My CA 125 is low, ultrasound suggests a solid cyst, MRI suggests no malignancy - but no guarantees. I think at this stage it is an elective surgery and not really something the Oncologist definitely suggests.

[Fiveft4]

Hi there :-) This is a tough choice, isn't it. I had to make the same decision earlier this month. I'm 47, have had my children (I thank God for this and feel pain for those women who are young and facing these issues) and found myself with an ultrasound and MRi showing 2 cysts and one solid mass. My CA125 was 9. I was bloated, sore and had bladder urgency and back/hip pain. I googled my symptoms and found this forum.

Here I learned the odds of everything being fine were in my favor, I learned that my symptoms were common to the women here (this made me feel better since doctors never thought any of this could be giving me the pain I was having) who I should consult (gyno/oncologist, which I did).

In meeting with the gyno/onc he gave me his opinion that all was probaly fine, but he also said there was no way besides surgery to know for 100% that all was well. He said he would be content to monitor every 3 months and said if anything changed he would recommend surgery. He also said he would do surgery, stating that he could understand the desire to know for certain that everything is fine.

I gave it 3 weeks of consideration and opted for surgery for a couple of reasons. 1) I wanted to know for sure what was growing inside me. 2) I wanted to be in control of when I would have surgery - unlike the uncertainty of the outcome of every 3rd month monitor session. My surgery was on 12/6 and I had both ovaries and tubes removed. I ended up having another solid mass and another cyst that had not been detected prior.

Thankfully, everything was benign and unlike some of the posts here recently, I have never been made to feel that I have not belonged here. For that I am thankful. The symptoms are the same in the beginning for many of us, and it helped me to get support not only from women here who have been diagnosed with cancer, but also from those who have not. I didn't care who it came form...and I still don't. If we ever get to a point where there is anger at the displaying of love, compassion, support and caring for others' then we are in a pathetic world indeed.

Best wishes to you as you make the decision that is best for you in your given situation. If there is anything I can do, let me know.

Sharon

[nyc lady]

Tough decision to make as no one can know for certain until there is a biopsy performed.  It is my understanding that if something is cancerous, chances are it will grow, change shape or something.  Also, if it isn't cancer, it will not become cancer.  With OvCa, unlike other types of cancer, a tumor, mass or cyst is either malignant or not, it won't turn from benign to malignant.  Many doctors will not perform surgery until the mass, cyst or tumor is over 5 inches as that is when they can begin to create trouble.  Removing the cyst is an option, but, remember, laproscopic or not, it is surgery, all surgeries carry their own risks.  Let us know how things go.
Remember, most cysts are benign, well over 90 percent of them, and OvCa is relatively rare.

[Mary 53]

Hi Sharon,

I just wanted to let you know that I posted to you over on the Menopause forum, but I just realized that the thread was from some time ago, so I thought I would mention it since you might not have seen it. I rarely go there myself as I am most comfortable here...and, so glad that you are comfortable here, too!

SIncerely,

Mary

[amazing1672]

Thank you for your valuable comments. At times just hearing some sense from others makes you feel better. Everyone around me (including doctors) is telling me this is nothing and I should not jump into doing a surgery but having it inside me and the constant 3 month follow up nightmare is having a toll on me. I think I will reach a decision  in Jan with a fresh year and positive thoughts in my mind.