endometriosis or cancer? need advice

[white_bear]

Dear Doctor,

I am 31 years old, was recently diagnosed with ovarian cysts and masses and need advice on how soon to have surgery.  On 8/21 my gyn palpated a cyst on my left ovary, about 4.5cm in size.  An ultrasound was scheduled for the beginning of my next period (9/12) and revealed the following:

<<
Impression: Bilateral adnexal masses, as described above.  On the left, there is an 8.0 x 6.0 x 4.7 cm cyst with diffuse low-level internal echoes as well as two cysts with internal echoes, measuring 3.0 x 2.3 x 2.1 cm and 1.9 x 1.5 x 1.9 cm.  On the right, there is a 5.3 x 4.8 x 3.5 cm cystic lesion with internal echoes, which is either contiguous to or within the right ovary.  The overall appearance is most suggestive of endometriosis.  Other etiologies, such as cystic neoplasm are considered less likely but cannot be completely excluded>>

CA125  is 81

Symptoms in the last couple months:
bloating and gas, abdominal pressure and mild pain (cramps at random times during my cycle, discomfort and occasional (a few times a day) light pain in the pelvic/abdominal, especially when moving.  
In the last week:
fatigue in my legs and soreness/ pain in my knees.

Family history: mother was diagnosed with breast cancer at 44, and then with stage 4 breast/ov ca (unclear which) at 61.  Both my mother and I tested negative for BRCA1 and BRCA2. I have never been diagnosed with endometriosis before and am not aware of any family history of endo either.

My gyn has recommended surgery in her office, and I am having trouble getting in to see a gyn oncologist before 2-3 weeks from now.  What is your impression and what would be your recommendations?  Do you think I could use extra tests (MRI, CT scan, etc)?  How concerned do I need to be?

Thank you in advance for your kind advice.

[white_bear]

Dear Doctor, thank you very much for your recommendations.  I will continue to work on getting an appointment with a gyn oncologist as quickly as I can. Thank you again.

[Annekathryn Goodman, M.D.]

Dear White Bear,

I think your doctor has done a great job working things up for you. You could get other tests such as a CT scan of the abdomen to check the rest of the abdomen for fluid and other tumors. You could also get an MRI which can give more information about the ovarian cysts. That can be helpful in sorting out the nature of these cysts.

But it is not completely necessary to get these additional test. I agree that you need surgery and that you should see a gyn oncologist. Most ovarian cysts are benign. Even with your family history, the most like thing this could be is endometriosis. But , yes these cyst could be malignant. that is not impossible. therefor you need surgery. 2 to 3 weeks is a hard wait but it is not unsafe.
best wishes to you