Complex Ovarian Cysts

[erika388]

Thank you for reading and responding.  I am new to this community.  My problem/diagnosis and questions are:

I was just diagnosed with a complex ovarian cyst on my right ovary, at 3 cm, via an ultrasound.  I had the ultrasound b/c I was very tired (exhausted) right b/4 my period, had some light, irregular spotting the week b/4 my period.  This has been happening for about 4 months.  

I am very worried about this cyst.  I do not feel comfortable with the wait and see approach.  My dr has recommended another ultrasound in a month.  I am meeting with her in a couple of days and am curious about the types of questions to be asking, for example should I ask for the tumor marker blood test, should I get a biopsy, should I get and MRI or CT scan (is one more appropriate than the other?), if I were to get this removed then am I more susceptible to future cysts on my other ovary, or other parts of female organs.  I have also read a variety of responses regarding the probability that a complex cyst may be cancerous.  Also, regarding the size, is it a small or medium size cyst.  Is the size an indication of how long it has been on my ovary.  If so, about how long has the cyst been growing?  Do complex cysts go away without any type of treatment?  Do complex cysts put you at higher risk for ovarian cancer in the future?  What causes a complex cyst and how "normal" is it for women to get complex cysts?


Also, are dermoids and chocolate cysts what are considered complex ovarian cysts?  Are there others?

I want to do everything to get it analyzed and removed.... am I being too anxious?  

Thank you for responding.
Erika

[MarieMichele]

I really don't know percentages, only that the risk increases with age and all post menopausal cysts get big attention from doctors. I think I have seen some messages in these forums where cancer was found along with a dermoid but I don' t think that means dermoids are malignant. I think benign cysts and malignant tumors could occur together. My doctor told me that a benign cyst is always a benign cyst and will not turn into cancer. They are more concerned that a benign-looking cyst can hide cancer that is growing simultaneously. These things seem to be as confusing for doctors as they are for us. When a cyst is complex, a doctor is more concerned because it is harder to dismiss them as harmless just using imaging tests.

[erika388]

Thank you so much for your response.  I do not have a copy of my report so I do not  have any further information.  I will get a copy on Monday.  I have also contacted a gyn-oncologist.  I now understand not to get a biopsy from what I have read.  I am having some pain in my leg as well.  

Any idea on the percentage of complex cysts being cancerous in women that are pre-menopausal?  I am 40.  Based on family history, I would not hit menopause until early 50s.

Is a dermoid a cancerous complex cyst?

I am also going to ask for the blood test and it sounds like an MRI might also be a good idea.

[MarieMichele]

There are no perfect answers. Ovarian cancer can be difficult to detect. It is rare compared to the number of cysts that are found and watched but it also needs to be detected early for the best outcome. 3 cm is probably still considered small and  could resolve on its own as long as it is not solid like a dermoid. Did you get any other description besides complex? I do not think it is possible to say how long it was there, but since you noticed symptoms for 4 months, it might be at least that old. It is useless to get a biopsy. If  the cyst contains cancer, it could be missed or the cyst could rupture, dispersing dangerous cells into the bloodstream. MRIs are great but very expensive and CT scans can expose one to excessive radiation. Both can give a better picture but neither will guarantee it is benign. Only removal and pathology of the cyst can guarantee that conclusion. Complex are more worrisome but they are not all cancerous either. CA-125 blood tests can give misleading results but if the reading is very high, then surgery should be considered. Ovaries that produce cysts are likely inclined to do so again and I don't think it has anything to do with surgery or cancer risk. Most are the result of hormone imbalances. Repeat surgeries can get more difficult and complicated so they should be minimized to only the most necessary procedures. Most cysts are benign but it is important to have a reputable gyno who knows when it is safe to wait or when fast removal needs to be done.