3.5 Complex Ovarian Cyst for 59 year old postmenopausal

[Holly51]

I am a 59 year old postmenopausal woman..can't even remember the last year I had my period.  I had a MRI for my back in January and they found a cyst on my ovary.  I had a vaginal ultrasound in July and it is still there, same size  3.5 cm.  It is a complex one.  They are sending me to the gynocologist.  What should I expect to prepare myself.

[hopeshell]

It is a good sign that your cyst has not grown in that time.  Most ovarian malignancies grow rather quickly.  But, any cyst can change over time.  Since you are post-menopausal and it has persisted so long, your doctor may want to remove it to be sure it doesn't become a problem.   As Auntcobbie pointed out in the above post, complex cysts 5cm or greater need to be removed and biopsied since they run a greater risk of malignancy.   There is something called a borderline ovarian tumor that can be very slow growing, yet still run a risk of spreading.  So, you can't really be sure any complex cyst is ok...especially when it persists.  But, it looks promising that you don't have other symptoms and it hasn't grown.

You should ask about having a consult with a gynecologic oncologist if you do end up being scheduled for surgery.  If malignancy is indicated during a frozen section, a gyn/onc can be available to step in and give you complete staging during the same surgery.  Your overall prognosis will be better if a gyn/onc is available to step in.  I hope all goes well.

Take care,

Shelly

[Auntcobbie]

Hi Holly---

The gynecologist should ask questions about general health and will probably want to do an internal to feel the cyst.  They'll want to know if you are having any pain. Once a cyst becomes 5 cm, the general rule of thumb is to remove it.  Smaller cysts tend to watched for 2 months and then re-checked.  Do you know if it grew between January and July?  If it is growing, they may want to remove it.

Also, if the gyno can get a sense of what type of cyst it is, this might sway their recommendation regarding removal.  With a cyst your size, I believe there is a good chance they could do surgery laproscopically if indicated.  This is an outpatient procedure (usually) and the healing process is quicker that open abdominal surgery.

Another thing they might do is order bloodwork, specifically the CA-125 test.  

Hope this helps.  You may be in a position to decide if you want to have surgery sooner rather than later.  You might want to be prepared for that.  Make a list of questions.  

Good luck,

Chris