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complex septated cystic mass in my left ovary measuring 8 x 7 x 6 cm
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complex septated cystic mass in my left ovary measuring 8 x 7 x 6 cm

I am 29 and I was having pain in my lower, left side and went to the ER 2-1-12. I had an internal and external ultrasound. I could tell by the length of time that the internal ultrasound was taking that something was going on. The doctor came in to tell me that I had a complex septated cystic mass in my left ovary measuring 8 x 7 x 6 cm that could be partially hemorrhagic and a small amount of fluid in the cul-de-sac. He asked for my Dr's name and left immediately to call them. Came back to tell me I must be seen in the next 24 hours and that my Dr was going to fit me in. I went to my GYN on 2-2-12,, she said that this type of cyst could be cancerous, but that there were other types of cysts it could be. Then she referred my to oncology surgeon and ordered an OVA1 blood test, saying that the test was 93% accurate in when looking for the possibility of cancer. I got the blood test done after I left her office and they say it will be up to 3 days for results. But no matter what I will have to have the cyst removed and checked for cancer. I have three kids, 4, 7, and 11 and I am very afraid. I am still waiting on a call from the oncologist to schedule my surgery.

I would be glad to hear any information that could help me understand whats going on. It was also be comforting to relate to others who may have had a similar experience.


This discussion is related to Septated Complex Cysts.
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16 Comments
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First, by far most cysts/masses are benign.  However, when they are more then 5 cm they can "twist" and cause serious problems, so the doctor is right in wanting to get it out.

It's best to have a gyn oncologist do the surgery, even if the cyst is benign.  They have three years of extra training and their results are going to be better.  You want to get this right the first time.  

My mass was 12-14 cm, on one ovary only with no spread.  Although it was cancer, it was caught really early and I'm celebrating 10 years since my surgery and chemo this year.   What you've reported above suggests that, worst case, you'd be a 1A like I am.  I recommend that you not worry about the results of the surgery until you know what the doctor and/or the pathologist says.  You'll have enough to think about making sure you and your family are ready for surgery.  

Let us know how it goes.  Good luck and God bless ...
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Thank you so much for your story. It is comforting to read about someones experience and for it to be a positive one.

I have been doing well with my thoughts on the situation during the day, when I am busy. But the evening prove to be tough for me emotionally. I don't want to worry, but it just hits me.

I am hoping to hear from the Dr tomorrow about my results. It could be Tuesday before I hear something, but I am focusing on getting positive information back.
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It's natural to worry -- and tough not to worry.  I guess I was suggesting that you TRY to worry about things you can do something about -- leaving a neat house, with food for the family, clean clothes, etc.  Explaining about surgery to the kids so they won't worry.  Assuing them you'll be home soon (you will, you know).  Lining up babysitters, etc.  Anything to distract you from the underlying worry, which may be a waste of time in the end.  

Again, good luck -- and keep in touch.  
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Test results: They say in premenopausal women a score greater than or equal to 5.0 indicates a high likelihood of malignancy. My score was 4.8
My Dr says this score is considered negative but is borderline and that I should be cautiously optimistic. The higher score could be a sign of another benign issue such as endometriosis. But we will not know for sure without the results from the biopsy.
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This is some of what I read about the test.

OVA1 is a blood test that measures serum levels of five proteins (transthyretin, apolipoprotein
A1, beta-2-microglobulin, transferrin, and the CA-125 II cancer antigen) believed to be markers of ovarian cancer, and uses
a proprietary algorithm (OvaCalc) to combine results into a single score (ranging from 00.0 to 10.0) indicating low- or highrisk
malignancy. Cutoff values for low- and high-risk stratification are currently set at 5.0 for premenopausal women and at
4.4 for postmenopausal women. The test is designed for adjuvant use and is not intended to be interpreted independently
from findings of current care methods to assess risk of malignancy prior to surgery in women with a confirmed pelvic mass.
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The only thing that will confirm whether this cyst is cancerous is not is a biopsy, which surgery needs to be done by a gyn/oncologist.  You only have one chance to get this right.  You are going to be scared, that is natural, but you are well informed and doing all the right things.  Don't hold too much in numbers with some of these blood test.  All of us are different.  For me, like a CA125, it didn't mean too much, it came down to the actual surgery and PET/CT scans.  
Keep us updated and Good Luck.

Jane
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Just found out my oncology appointment is February 23rd at 1:30pm.
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So glad I found this post. I went to the ED last nite. Dx with same type mass 10 x 9 x 8 cm. Waiting til monday for follow up. It's going to be a very long weekend. Very scared.
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On Feb-10-2012 Went back to the ER. They said I needed to See another Dr. sooner, so I was referred and will be seen by another GYN on Monday 2/13/12 at 9:30. I will still be seen by the Oncologist as well on the 23rd.

On Feb-13-2012 Better news from the second opinion today. She was a great Dr and talked to me for about 30min!  Her findings were more positive and she feels I should worry to much, but wants me to see the oncologist to be safe. The Cyst measures a little smaller than the first US on the 1st, so it seems to be shrinking/leaking when compared to the US done on the 10th. It is Hemorrhagic though and the amount of blood has increased some. But she says this will continue as the cyst continues to try to shrink, leak, reabsorb, resolve itself. It will be up to the oncologist as to whether they are concerned to remove it. They may just monitor me and follow up in two months for another Ultrasound.

I will update more after the next appointment on the 23rd.

On Feb-15-2012 Picked up a copy of my Ultrasound images and reports. The Cyst did decrease in size but the clot what is believed to be a hemorrhagic area/clot got a bit bigger.

The Cyst at first ultrasound 2/1/12 measured 8 x 7 x 6 and read as complex septated cystic mass.

The Cyst at second ultrasound 2/10/12 measured  7.4 x 6.2 x 4.9 and read as complex cystic lesion with increasing hemorrhagic component.
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So just got home a bit ago from my oncology appointment. During the exam, the Dr had a hard time finding the cyst. She said she feels a small amount of fullness but not a 7 or 8 cm cyst. She feels it is shrinking and from putting everything together, she feels it is a hemorrhagic cyst. I am set up for a follow up ultrasound on April 11th.

She said if there were something that stood out as a cause for concern toward a malignancy, they would have taken a look at it, using laparoscopy right away. But she really felt that a follow up ultrasound was the best approach.

So if it has resolved itself of shrunk more by then, no more will need to be done. But if there is more changes or it increases in size, they will go in to take a look at it. And if after looking at it, there is a reason to remove it or suspect malignancy, they will go from there.
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Thanks for sharing your story. I was just at my OB/GYN on Monday because over the weekend I had this intense pain in my lower right side. I honestly thought it was my appendix rupturing! Eventually the pain eased and I figured it wasnt that. But I still had this lingering pain. Anyway my OB/GYN did an U/S and found a 9x6 cm hemorhagic cyst on my right ovary. I'm 28, I have an 18 month old live a very active lifestyle. I am freaking out. My OB suggested waiting 2 weeks and then do another U/S to see if its shruck any. Reading your story has given me hope that it will.
Hope you are feeling better!
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Avatar_n_tn
I wish my doctor and radiologists could decide what I have...I have a 5cm primarily solid, complex, multiple septations cyst on my right ovary.  With my second US a month later, no change (tiny bit bigger) and a 2.2 complex cyst on my left :( could be anything from a dermoid cyst to cancer as stated on my sonogram reports...I had a CT this morning...Are they pretty accurate at telling you what kind of cyst it is?  My doc likes to watch and wait...not fun...how long did they recommend that you do that?  I feel like a second opinion is in order...I am exhausted from being scared.
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Went to the ER again for pain about two weeks ago. They said the cyst was the same size but filled with what was thought to be blood.  The oncologist moved my appointment up with them. I got another ultrasound last week then went in yesterday for the follow up appointment.

I am scheduled 4/27/2012 for a total hysterectomy and removal of left ovary and fallopian tube. The goal is to keep my right ovary, and they will do what it takes to make that happen. On ultrasound the right ovary seems healthy, so I should get to keep it no problem. It is suspected that I have Endometriosis and that my left ovarian mass is an Endometrioma (not suspected to be anything cancerous). This could change when they actually see everything, they will go from there. They will still be sending a frozen section off during surgery to screen for cancer cells.

I am scared, naturally, because it is major surgery. I am hoping everything goes well and that all my female problems will be over after this and I can move on with life.

They are doing the midline cut (up and down). I will be in the hospital for three days.

I have spent some time crying, but I am trying to stay strong and think about positive outcomes.
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A related discussion, 7.1 cm Complex Cyst was started.
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A related discussion, Late Updates was started.
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I have posted in my MedHelp journal,on my profile, all updates since my surgery last year, if anyone would like to read about what happened. My journal is public.

Robin
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