Internal echoes & septations?

[islandgurl]

A little background info, 6 cm complex cyst in '08 that resolved on it's own. No one seemed concerned about it.  Hysterectomy 2 months later, gall bladder out in '09, but have had the same pain since, ct scan, tvus dec '09, mrcp, in march'10, nothing on those, colonoscopy & egd in june , 3 pre-cancerous polyps removed, gastritis, july '10 tvus with the following report:  3.1 cm cyst in right ovary. there are internal echoes with septations. Possibly could represent a hemorrhagic cyst but it needs to be followed or further evaluated. previous scan in dec ovaries appeared normal. there is vascular flow to both ovaries.
My question is what does internal echoes & septations mean?  And what further evaluation could be done, other than another tvus?  When I had a 6 cm complex cyst it didn't say any of that, just complex "chocolate" cyst, which resolved on it's own in about 3 months. I lost weight when I had that cyst.  Now I have been putting on weight, and right after my colonoscopy I put on about 10 lbs. in 10 days.   My doctor was on vacation, so haven't talked to him yet.
Sorry this is so long!
Thanks for any insight or info.

[gaymon07]

my 19 year old daughter has a "complex cysts 4.2 x 3.8 x 4.2 in size on her left ovary. it says non-vascular internal septations? does anyone know what this means? Please i am going crazy!!!

[islandgurl]

Good news, I got into my gyno/surgeon in 13 days.

[islandgurl]

Didn't get to speak to the Dr, but to his nurse.  He has referred my to a gyn, can't get in until sept 20 for a consult.  I don't have a regular gyn, just a np for yearly exams. May try to get back into my gyno that did my hysterectomy 2 years ago.  Just hate waiting around.

[MarieMichele]

Chocolate cysts are more endometrial in nature, blamed more on the uterus than on ovaries.  You say you had a hysterectomy, so that should end future issues like that assuming the surgery provided a big cleanup at the time.

If you have a cyst now, one would have to think it is the ovary to blame.  Complex cysts with septations have walls/compartments within them.  Echoes is just technical-speak for how they read an ultrasound.  Echoes tell how the sound waves are traveling and whether a cyst is complex or not.  But it will not say if anything is cancer or benign.  Complex carries a higher risk because imaging tests cannot say what is making it complex.  "Possibly" in the report means they really don't know if it is hemorrhagic (bleeding) or not.  You would probably have pain and bloat if it were bleeding, and it could also mean it is trying to resolve.  

Surgical removal and pathology are the only truly conclusive ways to understand a cyst. At 3.1 cm it is still small enough to monitor, but your doctor needs to voice his opinion, especially considering all your prior medical history.  Mostly, yes, they just keep performing ultrasounds every few weeks or months if they chose a "watch and wait" approach.