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"Possible" dermoid?
I keep reading that dermoids seen on scans show hair/teeth, etc., but no one's said that about my situation, so I'm kind of scared that it's something worse and only a "possible" dermoid.
Here's the situation: the ultrasound technician said it looked like a dermoid to her while she was looking at it on the screen during the transvaginal and abdominal ultrasound.
Here's the radiologist's report word for word:
"Findings: A normal appearing right ovary is not seen. Within the right adnexa, there is a 3.8x8.4x3.6 mass mainly solid in appearance, however it does show some foci of increased echoes, as well as some ill-defined diminished echo activity at several sites. Definite free adnexal fluid is not seen.
Impressions: Complex mixed mainly solid right adnexal mass. There are no large cystic components identified. Possibility of dermoid is raised."
I've consulted with a gyn/onc and during the meeting he seemed to indicate that it was a dermoid too (talking about the problems of dermoids, etc.). I left the meeting with my surgery packet and said I'd call to schedule the surgery after arranging things with my work. With all this talk of dermoids, I didn't really think there was an urgent need for surgery, so I scheduled it in eight weeks during a two-week work break I already have coming up. (I work at home and have breaks between school terms.)
Now, I've been researching phrases like "complex mass" and "mainly solid", and I'm getting more scared that this "possible dermoid" might be ovarian cancer! It seems that being solid and complex increase the likelihood of malignancy.
Should I try to move the surgery up? Maybe the gyn/onc thought that "check my schedule" meant I'd clear it and try to schedule it in the next few weeks and not eight weeks later. I didn't talk to the doctor again when I called and scheduled, so there would be no reason for the scheduler I talked with to know anything about my specific case.
Am I panicking over 4-5 weeks of a treatment delay that wouldn't make a difference if it is ovarian cancer?!?
What does "some foci of increased echoes, as well as some ill-defined diminished echo activity at several sites" mean? Is this what images of teeth/hair look like on ultrasound (but they just don't put teeth/hair in the report)?
Here's the situation: the ultrasound technician said it looked like a dermoid to her while she was looking at it on the screen during the transvaginal and abdominal ultrasound.
Here's the radiologist's report word for word:
"Findings: A normal appearing right ovary is not seen. Within the right adnexa, there is a 3.8x8.4x3.6 mass mainly solid in appearance, however it does show some foci of increased echoes, as well as some ill-defined diminished echo activity at several sites. Definite free adnexal fluid is not seen.
Impressions: Complex mixed mainly solid right adnexal mass. There are no large cystic components identified. Possibility of dermoid is raised."
I've consulted with a gyn/onc and during the meeting he seemed to indicate that it was a dermoid too (talking about the problems of dermoids, etc.). I left the meeting with my surgery packet and said I'd call to schedule the surgery after arranging things with my work. With all this talk of dermoids, I didn't really think there was an urgent need for surgery, so I scheduled it in eight weeks during a two-week work break I already have coming up. (I work at home and have breaks between school terms.)
Now, I've been researching phrases like "complex mass" and "mainly solid", and I'm getting more scared that this "possible dermoid" might be ovarian cancer! It seems that being solid and complex increase the likelihood of malignancy.
Should I try to move the surgery up? Maybe the gyn/onc thought that "check my schedule" meant I'd clear it and try to schedule it in the next few weeks and not eight weeks later. I didn't talk to the doctor again when I called and scheduled, so there would be no reason for the scheduler I talked with to know anything about my specific case.
Am I panicking over 4-5 weeks of a treatment delay that wouldn't make a difference if it is ovarian cancer?!?
What does "some foci of increased echoes, as well as some ill-defined diminished echo activity at several sites" mean? Is this what images of teeth/hair look like on ultrasound (but they just don't put teeth/hair in the report)?
Thanks, Yvonne! I did A LOT of research yesterday, and I'm feeling more comfortable about waiting till April. From what I found in research, I don't have any of the other signs of malignancy in my ultrasound other than the mass being "mainly solid", and I've got age and statistics on my side that it will be benign.
Also, I've been able to feel it for over a year in my abdomen, and from what I've read, ovarian cancer tends to progress really fast which is why it's so deadly. Of course, I'm still nervous about malignancy, but I figure I've waited a year already, and if it is cancer, I don't think six more weeks will matter. I'm not in any pain. I think I got freaked out on Monday/Tuesday because I was having "gas pains" because I was trying these new fiber drinks, so I stopped those, and everything seems to be normal again today.
I was concerned about something else that was mentioned about the lump I feel in my abdomen. Is it really too high and in the middle to be the ovarian mass? Doesn't it have to be the ovarian mass since everything else on the ultrasound is normal? I mean, if that lump were anything else, wouldn't something else have shown up on the ultrasound?
Both my primary and gyn/onc felt it, but my primary did say the lump was higher than where the uterus would be. She at first thought maybe I had a fibroid that was growing up and out of the uterus, which is why she sent me for an ultrasound. The gyn/onc didn't say anything unusual about the location of the lump, and again, I was stupid and didn't ask. It is almost exactly in the middle about an inch lower than my belly button. If I lay on my right side for a while, it will actually move over to the left side, so it is then a little down and to the left of my belly button.
Also, I've been able to feel it for over a year in my abdomen, and from what I've read, ovarian cancer tends to progress really fast which is why it's so deadly. Of course, I'm still nervous about malignancy, but I figure I've waited a year already, and if it is cancer, I don't think six more weeks will matter. I'm not in any pain. I think I got freaked out on Monday/Tuesday because I was having "gas pains" because I was trying these new fiber drinks, so I stopped those, and everything seems to be normal again today.
I was concerned about something else that was mentioned about the lump I feel in my abdomen. Is it really too high and in the middle to be the ovarian mass? Doesn't it have to be the ovarian mass since everything else on the ultrasound is normal? I mean, if that lump were anything else, wouldn't something else have shown up on the ultrasound?
Both my primary and gyn/onc felt it, but my primary did say the lump was higher than where the uterus would be. She at first thought maybe I had a fibroid that was growing up and out of the uterus, which is why she sent me for an ultrasound. The gyn/onc didn't say anything unusual about the location of the lump, and again, I was stupid and didn't ask. It is almost exactly in the middle about an inch lower than my belly button. If I lay on my right side for a while, it will actually move over to the left side, so it is then a little down and to the left of my belly button.
I guess a 4 week delay wont have a massive in impact on cancer treatment, but that is me just guessing, but I would imagine a 4 weeks delay could give time for cancer to spread! but this is all guess work, different cancers have different forms of how aggressive they are, and no one knows that it will be until its out and tested.
From experience I would just get it would, I thought the same delay surgery because I was scared, but then time catches up and you come to that day you have to have it either way, so get it out the way now, you will only feel the same if not worse in weeks to come, as I ended up panicing and thinking the worst, having time to dwell on it. If you have the slightest worry its cancer, than the thought of that I am sure you would just want it out now and the surgery itself you wouldnt even worry about, you will be telling them to get it out if you think about it. No-one wants to have major surgery, its scary, and if I think of mine being benign I get scared of the surgery and would rather forget it and leave it, but if I think about the chance of it being malignant the fear goes and I just want it out.
I had my first anesthetic in November, I had keyhole and I was terrified, scared I wouldnt wake up, scared I would wake up during it! But I went out literally like being switched off like a light and switched back on again seconds later, the surgery was 2 hours, I had no pain whatsoever, granted I only had a 1 inch incision beneath my belly, but stil it was a cut and felt no pain, even when the meds had wore off, I went home 4 hours later and thought it was a breeze. I admit I am not looking forward to this next surgery as he wants to do the bigger open incision in my bikini line, and I will be pregnant too, so thats an added worry, but needs must, I just keep thinking to myself I will be out like a light and I will face the recovery afterwards, at least I know it will be over with.
Bottom line is it has to come out either way, whether its now or put it off. Personally benign or malignant best to get it out now, as benign cysts can also cause torsion/twisting or the ovary and rupture of infectious fluid.
Good luck and best wishes
From experience I would just get it would, I thought the same delay surgery because I was scared, but then time catches up and you come to that day you have to have it either way, so get it out the way now, you will only feel the same if not worse in weeks to come, as I ended up panicing and thinking the worst, having time to dwell on it. If you have the slightest worry its cancer, than the thought of that I am sure you would just want it out now and the surgery itself you wouldnt even worry about, you will be telling them to get it out if you think about it. No-one wants to have major surgery, its scary, and if I think of mine being benign I get scared of the surgery and would rather forget it and leave it, but if I think about the chance of it being malignant the fear goes and I just want it out.
I had my first anesthetic in November, I had keyhole and I was terrified, scared I wouldnt wake up, scared I would wake up during it! But I went out literally like being switched off like a light and switched back on again seconds later, the surgery was 2 hours, I had no pain whatsoever, granted I only had a 1 inch incision beneath my belly, but stil it was a cut and felt no pain, even when the meds had wore off, I went home 4 hours later and thought it was a breeze. I admit I am not looking forward to this next surgery as he wants to do the bigger open incision in my bikini line, and I will be pregnant too, so thats an added worry, but needs must, I just keep thinking to myself I will be out like a light and I will face the recovery afterwards, at least I know it will be over with.
Bottom line is it has to come out either way, whether its now or put it off. Personally benign or malignant best to get it out now, as benign cysts can also cause torsion/twisting or the ovary and rupture of infectious fluid.
Good luck and best wishes
Thanks, Yvonne! I called today and talked to the nurse and asked whether it was 'urgent' or not, and she said that the doctor talks to them usually first if scheduling is urgent and wouldn't have let me leave the office without scheduling if it were urgent. It didn't really put my mind to ease, and now I'm kicking myself that I asked it as a 'question' instead of just trying to reschedule. I'm going to get a good night's sleep and then see how I feel about all of this tomorrow if I want to reschedule earlier.
In my mind, the pros of surgery in six weeks is 1. no work to worry about while recovering, 2. time to "mentally prepare" myself before the surgery since I'm scared of the surgery itself (anesthesia, pain, etc.), and 3. time to physically prepare myself for surgery too (cut sodium to reduce swelling, etc.). Of course, the con of surgery in six weeks is that IF it's cancer, I'll kick myself for not doing the surgery earlier!
I suppose my big question is, would a 4-week delay in beginning ovarian cancer treatment really make a difference in overall outcomes?
In my mind, the pros of surgery in six weeks is 1. no work to worry about while recovering, 2. time to "mentally prepare" myself before the surgery since I'm scared of the surgery itself (anesthesia, pain, etc.), and 3. time to physically prepare myself for surgery too (cut sodium to reduce swelling, etc.). Of course, the con of surgery in six weeks is that IF it's cancer, I'll kick myself for not doing the surgery earlier!
I suppose my big question is, would a 4-week delay in beginning ovarian cancer treatment really make a difference in overall outcomes?
Hi There,
Firstly I can so much sympathise with your worry and anxiety, I know exactly how you must be feeling along with lots of other ladies on this site. You will find the internet will scare you more than its worth, believe me, it has sent me into a state of panic and depression at times. Try not to take literally what that the internet says, that is the mistake I have made, people can put anything on there that isnt exactly true, lots of benign growths are solid. Firstly dermoids to have a variety of appearances on ultrasound, and true diagnoses is only when it is removed and tested. I had a 10cm cyst/tumour found back in October last year that they thought was an endometrioma, the ultrasound tech at the time decribed it as well circumscribed with fine internal echoes - in the right adnexa, right ovary cannot be seen.
Try to cut a Long story short, they just drained it (they shouldnt have) as it was still there 6 weeks later, this time showing as a 7cm well circumscribed mass of mixed echogencity (showing more solid). It wasnt an endometrioma as decribed on ultrasound, and now they suspect a Dermoid cyst because of yellow fluid extracted. The fluid was proved benign, but I do worry the mixed echgencity (solid parts) left behind isnt.
Out of 4 tech's that have done my ultrasound none of them have said they can see teeth or hair, infact my gyno said there was no hair in the extraction so he wasnt exactly sure what it was! All they know is that it is inside my ovary and dermoids mainly form inside the ovary (thats why the ovary could not be seen as it had stretched so big to 10cm inside my ovary on ultrasound this actually was my ovary, but they could not confirm this as the normal size of an ovary is approx 2-3cm). It therefore suspect your cyst is inside your ovary if the maxium size is 8.4cm and ovarian tissue cannot be seen. But this is just guessing
I was due to have my growth removed completely 11 Jan, only to find out I was pregnant, so surgery cancelled, as you can imagine this gave me more time to panic, think the worst and talk myself into the worst and not concentrate on my baby. I decided to wait until my second trimester to have this removed. Which is now next Tuesday 8th March when I finally have the operation.
Without trying to scare you it is better to have surgery sooner rather than later, mine has just dragged out with the set backs and give me more time to worry, you have not said what your age is, but I am assuming you are pre-menopause so as Shelly says this is most likely to be benign, and dermoids are common in pre-menopausal age. Complex cysts (solid/cysts) are more worrisome, but odds our in our favour, its really hard not to worry, I have been worrying for the last 4 months, now I worry about the operation and my baby, but got to hope for the best and needs must.
My suspected dermoid has been hitching a free ride for too long and I just want it out. I hope that you can schedule surgery sooner, do not wait, even if your Gyno/Onc is fine with this, as it will just send you crazy if you are prone to worry.
I found stopping reading the internet made me feel better and worry less, as everyones situation is different, and cannot compare. When I was reading alsorts I also started to think I could feel symtoms, when in fact I probably have no symtoms but now every little bit of pressure, pinch, dull throb I wouldnt notice if I still didnt know I had the cyst.
I also doubt the hard lump just below your belly button is the cyst/dermoid. Your ovaries are low down deep within your pelvis and behind your pelvic bone, mine was 10cm (so bigger than yours) and it could not be felt on my abdomen. The lump could be a fatty tissue, does it move freely? Maybe get the doctor to look at this.
I think diminished echo means there is not sign of solid tissue in those areas, these areas would have shown black, which would indicate cystic parts, any solid/semi parts show as white shadows/echos on the ultrasound. Dermoids contain fatty greasy yellow fluid, that is thick, this can also show as echogenic even though its a form of fluid, as its not watery clear fluid. The hair and glands produce the yellow greasy fluid.
Apologies for the long repsonse, but I have been there where you are and my advice is to have it out asap, so you are not in the waiting/not knowing limbo state, as this can drive you crazy.
I wish you lots of luck, and hope that you are able to get your operation brought forward
Yvonne x
Firstly I can so much sympathise with your worry and anxiety, I know exactly how you must be feeling along with lots of other ladies on this site. You will find the internet will scare you more than its worth, believe me, it has sent me into a state of panic and depression at times. Try not to take literally what that the internet says, that is the mistake I have made, people can put anything on there that isnt exactly true, lots of benign growths are solid. Firstly dermoids to have a variety of appearances on ultrasound, and true diagnoses is only when it is removed and tested. I had a 10cm cyst/tumour found back in October last year that they thought was an endometrioma, the ultrasound tech at the time decribed it as well circumscribed with fine internal echoes - in the right adnexa, right ovary cannot be seen.
Try to cut a Long story short, they just drained it (they shouldnt have) as it was still there 6 weeks later, this time showing as a 7cm well circumscribed mass of mixed echogencity (showing more solid). It wasnt an endometrioma as decribed on ultrasound, and now they suspect a Dermoid cyst because of yellow fluid extracted. The fluid was proved benign, but I do worry the mixed echgencity (solid parts) left behind isnt.
Out of 4 tech's that have done my ultrasound none of them have said they can see teeth or hair, infact my gyno said there was no hair in the extraction so he wasnt exactly sure what it was! All they know is that it is inside my ovary and dermoids mainly form inside the ovary (thats why the ovary could not be seen as it had stretched so big to 10cm inside my ovary on ultrasound this actually was my ovary, but they could not confirm this as the normal size of an ovary is approx 2-3cm). It therefore suspect your cyst is inside your ovary if the maxium size is 8.4cm and ovarian tissue cannot be seen. But this is just guessing
I was due to have my growth removed completely 11 Jan, only to find out I was pregnant, so surgery cancelled, as you can imagine this gave me more time to panic, think the worst and talk myself into the worst and not concentrate on my baby. I decided to wait until my second trimester to have this removed. Which is now next Tuesday 8th March when I finally have the operation.
Without trying to scare you it is better to have surgery sooner rather than later, mine has just dragged out with the set backs and give me more time to worry, you have not said what your age is, but I am assuming you are pre-menopause so as Shelly says this is most likely to be benign, and dermoids are common in pre-menopausal age. Complex cysts (solid/cysts) are more worrisome, but odds our in our favour, its really hard not to worry, I have been worrying for the last 4 months, now I worry about the operation and my baby, but got to hope for the best and needs must.
My suspected dermoid has been hitching a free ride for too long and I just want it out. I hope that you can schedule surgery sooner, do not wait, even if your Gyno/Onc is fine with this, as it will just send you crazy if you are prone to worry.
I found stopping reading the internet made me feel better and worry less, as everyones situation is different, and cannot compare. When I was reading alsorts I also started to think I could feel symtoms, when in fact I probably have no symtoms but now every little bit of pressure, pinch, dull throb I wouldnt notice if I still didnt know I had the cyst.
I also doubt the hard lump just below your belly button is the cyst/dermoid. Your ovaries are low down deep within your pelvis and behind your pelvic bone, mine was 10cm (so bigger than yours) and it could not be felt on my abdomen. The lump could be a fatty tissue, does it move freely? Maybe get the doctor to look at this.
I think diminished echo means there is not sign of solid tissue in those areas, these areas would have shown black, which would indicate cystic parts, any solid/semi parts show as white shadows/echos on the ultrasound. Dermoids contain fatty greasy yellow fluid, that is thick, this can also show as echogenic even though its a form of fluid, as its not watery clear fluid. The hair and glands produce the yellow greasy fluid.
Apologies for the long repsonse, but I have been there where you are and my advice is to have it out asap, so you are not in the waiting/not knowing limbo state, as this can drive you crazy.
I wish you lots of luck, and hope that you are able to get your operation brought forward
Yvonne x
Thank you so much for responding. I'm literally just waiting for the doctor's office to open to call and ask about this. I've just been so stupid about this whole thing so far. I noticed a hard lump just beneath my belly button about a year and a half ago, but I've been living overseas and I really didn't want to go to a doctor in the place where I was.
It doesn't actually bother me (no pain, etc.) but I've been noticing it more as I've been losing weight, and now I realize I've been having those "vague" ovarian cancer symptoms (feelings of fullness, etc.) for a few months now off and on (not consistently) and I just wrote them off as random "stomach problems" or related to my new dieting and exercising.
If the mass is big enough to actually feel it (when I'm laying flat on my back), then would it be causing more serious problems if it were ovarian cancer? I mean if I first noticed it a year and a half ago as a lump, then if it were cancer, would it likely have killed me by now or at least spread to an organ that would be causing other problems?
It doesn't actually bother me (no pain, etc.) but I've been noticing it more as I've been losing weight, and now I realize I've been having those "vague" ovarian cancer symptoms (feelings of fullness, etc.) for a few months now off and on (not consistently) and I just wrote them off as random "stomach problems" or related to my new dieting and exercising.
If the mass is big enough to actually feel it (when I'm laying flat on my back), then would it be causing more serious problems if it were ovarian cancer? I mean if I first noticed it a year and a half ago as a lump, then if it were cancer, would it likely have killed me by now or at least spread to an organ that would be causing other problems?
I can relate to your situation and it is stressful! But, yes, you really should get the surgery as soon as possible. Odds are with you that it is benign. But, there is no way to know if a mass is benign or malignant without surgical removal. As you already know, any complex mass has a "chance" of being malignant. I was originally told that they thought my mass was a dermoid or endometrioma and I ended up having early staged ovarian cancer. Thankfully, it was caught at Stage 1 and I am now still cancer free 4 years later. I was 37 at the time, with no family history or risk factors. So, you can never say you are in the clear. My gyn/onc was reassuring before surgery that it was benign based on the findings and odds. But, frozen section during surgery proved otherwise.
It just isn't worth taking any risk in waiting when you have any "chance" of malignancy. That said, it is sometimes not possible to get surgery right away. So, don't panic if you are left with this delayed surgery date. But, if I were in your shoes, I would definitely call and try to get in sooner if you are the one who delayed it until this date. Ovarian cancer can grow and spread rather quickly depending on the type. The key to survival and cure is catching it early! Keep us updated on how you are doing!
Shelly
It just isn't worth taking any risk in waiting when you have any "chance" of malignancy. That said, it is sometimes not possible to get surgery right away. So, don't panic if you are left with this delayed surgery date. But, if I were in your shoes, I would definitely call and try to get in sooner if you are the one who delayed it until this date. Ovarian cancer can grow and spread rather quickly depending on the type. The key to survival and cure is catching it early! Keep us updated on how you are doing!
Shelly
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