ovarian cysts and elevated ca125

[lmc25]

I have a prev. hx of endometrosis , an endometrial ablation in 2005 and have had severe pelvic pain about 3-4 per month for a year. In between I am generally pain free. Had a US last August and it showed a cyst. This month the pain was especially bad, with severe cramping and pain in pelvic area and lower back, hip and thigh pain. They did another US and found a cyst on L Ovary and my L tube was swollen and a cystic structure on my uterus. They did bloodwork and scheduled a MRI of the pelvis. We originally scheduled a laporoscopy with removal of l ovary and tube. At that time the dr felt 98% certain is was not cancer but I when went to have my MRI yesterday they told me in the dr wanted one of the abdomen too. When I met with my Dr he said my CA125 was elevated (336) and the MRI showed a 2.3cm cyst on L ovary, hydrosalpinx, a cystic structure on my uterus (possibly a degenerated fibroid)and some fluid in my cul-de-sac. My doctor scheduled me for a TAH/BSO next week and while he still feel pretty confident it is not Cancer he is less confindent (85%) due to my elevated ca125. I know w/o a biopsy we can not tell for sure but does cancer look differently on a US and MRI than a benign cyst or endometrioma? I also know that CA125 can be elevated for reasons other than CA but some of the post I read say only to as high as 100 with endometriosis and my is over 300. I am 42 years old and have 3 childen and I am pretty scared right now. thanks for your help

[Annekathryn Goodman, M.D.]

Hi There,

You have a good doctor and I agree with his recommendation of a TAH/BSO (total abdominal hysterectomy, bilateral salpingo-oophorectomy (removal of the right and left fallopian tubes and ovaries)). I also agree that it is unlikely to be cancer but with the elevated CA 125, your pain, and the scan findings - completely removal of the pelvic organs is the most careful intervention.

I have seem endometriosis and other benign tumults in the pelvis elevate the CA 125 in the hundreds.

I know you are scared right now but you are in good hands.
best wishes

[KF24]

Dear imc25,
I am in a similar situation.  Can you tell us how things turned out for you ?