Drainage of a complex cyst (Dermoid)

Hi All, wondered if anyone has any advice.

I live in England. My partner and I have been trying of baby for a year without success, we therefore proceeded down the routes of fertility testing.  Part of this included a transabdominal ultrasound, the radiologist reported a 10cm x9cm  ovarian mass, well circumscribed with fine internal echoes, suggestive of endometrioma or hemmoraghic cyst.  I was referred within 2 days to a Gyno, had all the bloods test (which were normal) and then booked in for surgery 2 weeks later.

Before the surgery I discussed with my Gyno the fact we thought I had endometriosis (based on my menstural symtoms (symptoms)) due my fears of having laportomy and him doing invasive surgery on the endometriosis he agreed to to a first look laporscopy.  When he went in, I didnt have endometriosis, instead he said what he saw a vary enlarged smooth walled ovary, benign looking.  He decided to drain it.  The fluid was yellow, not clear yellow as in a normal function cyst, but more milky yellow.  I was sure when I came round from the anesthetic he said it was a dermoid.  

Since the operation I have been worrying and re-searching dermoids, because I thought he really shouldnt have drained it, regardless of what it was, the original scan proved to show it had echoes and wasnt simple. I know dermoids have small chance of turning malignant, however, I have read this is likely from 10cm onwards and in post menopauseal women. ( I am 34).  One study I read in a Japanese medical site on a survery they had done, was 10cm plus dermoids have 87% of malignancy!  I have since worried so much about this, that I went to see my Gyno ( I gate crashed his clinic without an appointment)  and explained what I had researched, I know it annoys doctors their patients read the internet, but this was a study conducted over a few years.  He said it was total rubbish, and he has took out 100's of dermoids all sorts of sizes that are benign.

He actually said he cannot tell me what type of cyst it is, he said the fluid was yellow, but not quite like that of a dermoid, and not the same as a functional cyst.  He expects it still to be there and I now have another scan tomorrow.  Although the fluid is benign, the sac may not be,   I am the worlds worse worrier, I am concerned he has punctured the cyst and this could spread cells.  He shown me pictures of before and after, the cyst was inside my ovary, he went through my abdomen with a needle and straight through the ovary.  It was then just completely collapsed.

Has anyone ever ended up with a complex cyst drained?  

Thanks for reading

Yvonne

[hopeshell]

Hi Yvonne,

Usually, a complex cyst is removed intact.  But, your doctor made a call and odds are with you that it was benign.  I would think a dermoid would have shown fat, hair, etc....things that clearly showed it was a dermoid.  This may be why your doctor has called it a dermoid, but the description sounds more like a mucinous tumor.  Many mucinous tumors are benign.

One type of tumor that looks like you describe is a mucinous borderline tumor of low malignant potential.    In general, they behave in a benign fashion, but they can recur on the same or other ovary and they rarely can spread.  They are considered a malignancy, but most types have an almost 100 percent survival rate.  In fact, many doctors disagree on if they are benign or malignant.  Women with these types of tumors often have their fertility spared and then have a complete hysterectomy after completing their family.  Close follow-up is recommended for this type of tumor to make sure they don't recur.    

You should talk to your doctor about getting transvaginal ultrasounds to keep an eye on the ovary and make sure the cyst doesn't recur since you don't have definitive pathology on your tumor.  Even recurrent borderlines and early staged malignancies can usually be cured with surgery.  Odds are in your favor that this was benign.  If it was a dermoid, it would be very rare to have malignant transformation.  Good luck on conceiving!

Shelly

[Sconnie]

Hi Shelly,

Thanks for your reply, I have surgery again in 3 weeks to have the thing removed completely, its now showing as mainly solid (which is very worrying) but they are saying it will do because its been drained of the fluid.  Even thought the fluid is benign, I am worried so much that the tissue left is not, and even more so now is showing mainly solid.  3 weeks cant come quick enough.

Regards
Yvonne

[ska4life1986]

i hope all this worrying wont ruin your christmas i know how stressfull it is i have been there i was the same as you and had myself convinced and all turned out well stay strong and keep posted you will get support x

[Sconnie]

I am glad it all turned out well for you, it must have been a massive relief I can imagine.  I know what you mean, you do convince yourself.  I just wish he had took it back in November, but he said he had to think conservatively about my fertilty (trying for a baby) and it looked like a large functional cyst, so he drained it, six weeks later its still there, but this time showing solid, which totally scared me, but he explained it will do because he took the fluid away, and what is left is the ovary and the sac inside.  The cyst is actually inside my ovary, there is nothing on the surface, (he showed me the surgery pictures, it was like a massive balloon)but I am worried the next 3 weeks it will start to change and just want it out right now.  He tried to get me in next week, but couldnt, he said he could see my aniexty and fear, but has assured me its most likely benign, due to the fluid being okay and my age, still you end up thinking the worst and I know its not good to think that way.  However like you say, you convince yourself, its horrible and wouldnt wish it on anyone, the waiting is just horrible, so unfortunatley I do have it hanging over my head over Xmas. x  

[ska4life1986]

yes i totally understand ,but i must say seems like you have a great doc and he is been very honest ,thats great as many woman found their doc not helpfull ,i am 24yrs old single with no family and had dermoid that twisted i lost my ovary and fallopin tube and i have pcos on my remaining ovary but please god one day i will have a family never loose hope we have to have hope in our lifes god will be good to you hand it over x

[Sconnie]

Yes, my Gyno has a very good reputation of 30 years, he is very gentle and patient, although I have questioned and questioned him so many times I think I may have frustrated him, I want to trust him so much, but I know you just dont know until its out that is benign, but he has told me he doesnt think its cancer.  I have gatecrashed his clinic (without an appointment) because of worry and he has agreed to see me, and I have had all my appointments brought forward, so I know he had done his best, considering its NHS, he also does private work, and I begged him to do it next week (despite it being Xmas) he phoned his secretary there and then and said he had a young lady in distress and what was his surgery like for next week, but unfortunately it was full, and I guess they have to prioritise.  He said if he gets a cancellation he will put me in it.

I am sure you will have your day when you become a Mummy.  You are still very young, and have one ovary, that will still be ovulating every month and when you meet your prince charming I bet it will happen.  I have wanted children for 10 yrs, with my ex partner of 17 years (we were together since school) we tried for 3 years and it didnt happen, we had tests (but never got as far has having a scan for cysts!) and he had no so good sperm, so we put it down to him, then we split, he went off and married someone else and has a baby now, so really it was me with the problem.  I am with my new partner of two years, he already has 3 children to his 1st wife, but wants one more can you believe!   and this is how we found me to have this cyst after trying for the last year, I ended up having a scan.  But you know, life works in funny ways, I believe I got with my partner because he already had kids, and maybe because I cannot have them, they are my substitue family, they are good children and I never thought I would contemplate being with someonw who already had 3 kids!, I have come to terms with the fact I may not be a mum, if I am honest, as long as I am heathly and this growth is benign, that is all I could wish for right now.  As long as you have your friends and relatives and your health, that is the most important thing in the world.  

You have loads of time to meet someone and have a child.  At 24 I didnt know what I wanted!  It will all come when the time is right hun.  x

[ska4life1986]

yes its very weird the way life is layed out for us ,your user name really caught my eye as i have cousins and their nick name is sconnie first i thaught is it one of them ha ,hopefully this will be all behind you soon and all go well ,i suspose i was lucky i dident know i had a cyst i just got very sick and was rushed off and when i woke all was over and done with so i dident have the waiting game for surgery ,when i had my surgery i was told i my chances of fertillty were halfed and they also said i had signs of pcos and when i go to out patients to make sure to get tested for it ,so it took 3 months for bloods to come back and now they are saying i have pcos but this puts fertillty on the remaining ovary not good ,and i have weight problem that dont help ,but about a year before all this came about i went to see a physic and he told me you will belive that you cant have a baby but i can telll you it will happen and when i came out i said what a waste of money  and now its just weird oh well we can never say never keep in touch as you need support lisa x

[Sconnie]

Hi,  my friends call me scone because it rhymes with yvonne ha. Or vonnie as I sometimes get called rhymes with sconnie! What will be will be hun, take each day as it comes and when you meet the right man then only start thinking of children. You have lots of time yet. I'm 35 next month and I've wanted children for so long, but if I don't then I have my lovely partner,  friends and family, and I will find something else to concentrate on like lovely holidays. Also I read your other ovary takes over and ovulates every month. As my boyfriend keeps saying to me,  think good and good things will happen  xx