Ovarian Masses

I have had a complex ovarian cyst on my left ovary for about a year now. My OB has had me do vaginal ultrasounds every two months to keep an eye on it. With my last test it was discovered that I now have two ovarian masses on my right ovary as well. The report describes one as complex (like my other one), but the other one is described as "non homogeneous non vascular". I have not heard of these terms before in relation to ovarian masses and would like to know if I should be worried. My OB is sending me for CA125 bloodwork as well.
Possibly unrelated, he also recently found a mass in my left breast, but it did not show up on my mammogram, but an enlarged lymph node in my left armpit did.
All of these masses popping up all over have me very scared....please let me know if my fear is founded or not!

[Dr. Kokil Mathur]

Hi

Thanks for the post.

Yes, you should be concerned, especially if you have a family history of breast or ovarian cancer and since you have masses on both sides. However I am not sure in which age group you are as “benign tumors and causes of ovarian masses can occur in all age ranges. Malignancy of the ovary definitely is higher in older women and lower in frequency in the younger ages.” Your CA125 test will help detect ovarian cancer, though it’s not very confirmatory. “CA-125 is an ovarian cancer antigen test but it is also positive in many cases of benign pelvic and abdominal disease, especially premenopausal. Fibroids, diverticulitis, liver disease, benign ovarian tumors, endometriosis and other nonmalignant sources can cause an elevation in CA-125.” A biopsy of the mass is most confirmatory.

Generally a mammogram is confirmatory and if it could not detect a lump in breast, then it is fine. However the lymph node in axilla cannot be ignored especially since there are ovarian masses.

However not all ovarian masses are cancer. “There are many benign pelvic conditions that can appear on ultrasound as worrisome for malignancy. These include: benign epithelial and functional ovarian cysts, hemorrhagic ovarian cysts, endometriosis, dermoid cysts (benign teratomas), ovarian fibroids, uterine fibroids, fimbrial cysts, hydrosalpinges (swollen, fluid-filled faloppian tubes), pelvic abscesses, pelvic adhesions, bowel adhesions and adenomyosis.”

I am sure once the CA125 results come your doctor will do a more rigorous follow up.
Please refer: http://www.wdxcyber.com/ncanc08.htm


However it is difficult to diagnose without examining. You may also need to take some more blood tests, biopsies etc to reach a diagnosis. Hope this helps. Please let me know if there is any thing else and do keep me posted.

[Unipuff]

Thank you very much for your feedback....I really appreciate it. There is no family history of cancer that I am aware of (a lot of my family does not keep in touch due to divorces and such), but it is possible. As far as my age group, I just turned 39 this week.
One thing you mentioned that could show as ovarian masses was bowel and pelvic adhesions.....I actually just got a scan with contrast for that about a month ago because I am a gastric bypass patient (5 years ago) and started to have some problems with pain everytime I would eat so they were looking to make sure there were not any adhesions from the scar tissue, but they did not see anything obvious at the time other than also seeing these ovarian masses and having a bowel backup (they treated with stool softener).

I go for the CA125 bloodwork this afternoon, so I will let you know how that comes back. Thanks again for any feedback!! Oh, can you also tell me what it means that one of the masses is "non homogeneous"?

[Dr. Kokil Mathur]

Hi
Generally a homogenous (same type all throughout) mass is a solid tumor and a non-homogenous (not the same type all throughout) mass is a cystic type of lesion. It could also be non-homogenous due to gas. Generally a cancer mass is homogenous but there are exceptions too.
Please do let me know when your results are available.

[Unipuff]

Thank you!! That makes me feel a little better and less anxious while I wait for my results. I will keep you posted.

[Candace77]

I recently had a physical/pap.  Upon examination was found to have "enlarged ovary", swollen lymph node, and bladder infection.   My doctor suggested I have an ultrasound which I did.  My doctor recently called and said I have a 5-7 inch "mass" on my left ovary.  He also repeated my urine, CBC, and more x-rays.  He told me that I had "Lymphocytes" in my urine, but did not explain what this meant.  I have an appt. for a CAT scan and another OB/GYN appt. next week.  I have looked everywhere on the internet for some information and everything having to do with Lymphocytes points to cancer.  I am 31, no history of ovarian or breast cancer.  I am a relatively healthy person, other than occasional anemia, and childhood Epstein Barr and Chronic Fatigue Syndrome.  I have had overactive lymph nodes before as a child, but was never diagnosed with anything serious.  My mother has Grave's Disease and was misdiagnosed for years and told she had a psychological problem.  Everything I have read about suggests some sort of Auto Immune Disorder.  I am frustrated and scared because I don't feel like anyone is explaining to me what is going on...if anyone could offer any advice I would greatly appreciate it.  By the way, my husband is Active Duty and this is a military medical facility and it's next to impossible to ever speak with a live human!!!
Thank you
Candace

[Dr. Kokil Mathur]

Hi

White blood cells and lymphocytes (in small number) in urine are present in urine infection and stones. However, I am sorry to say but lymphocytes in urine are also  present in bladder cancer. What is more important is whether they were normal lymphocytes or some mutant ones.

What was the result of your CA125? Ovarian masses need to be investigated in detail only because ovarian cancer does not have many symptoms. Biopsy of the mass is most confirmatory.

Take care! Do keep me posted!