Next step ovarian cysts

[Sharon2714]

hello i am new here.  
My family doc thought i was pregnant when she felt a large mass with no period.  Sent me for an ultrasound when i was hcg negative suspecting adnexal mass.  and here it is ... 10cm complex with septate rt ovary, 5 cm complex on left ovary.  I had a folow up ct on friday and i am waiting on those results.
42 yo with G4 P3 AB 1 (miscarriage) married 22 years(same man) with no birth control (just always thought i was lucky).  Menarche 12yo regular periods over life until last month.  I have jad GERD for 2 yrs, occ bouts diarrhea/constipation, bloated like crazy, swelling in pelvic area, chin hair (i know i sound like a real catch don't I lol), breast seepage (normal mamogram).  My aunt had a 20 lb abd tumor removed in early 1990.  My sister has stage 3 OVCA on third round of chemo. 2 other sisters have neg history.
1.  Given my family history, how strongly should i consider laproscopy/removal whether my fam doc agrees or not?
2.  Any other tests in order here ( i have great insurance) or just continue on this path?
Any advice greatly appreciated and Good Luck to all of you who are on this forum.

[Annekathryn Goodman, M.D.]

Hi There,
you have had a good evaluation. seeing a gyn oncologist is the right next step. It must be very scary with your family history.
You should get a CA 125. If that is in the normal range, a laparoscopy for a 5 cm cyst is appropriate. If that CA 125 is elevated, your doctor may still recommend looking with a scope. But he/she may also recommend a bigger incision for the surgery.

Also this may be a good time to consider the prophylactic removal of both your ovaries and tubes given your family history. Please let us know how everything goes
take care

[Sharon2714]

and of course i forgot to mention pain controlled with ibuprofen (800 mg) and heat, urinary frequency urgency and incontinence.  I was active duty marine for 8 years and involved in asbestos removal project for about 9 months.

[Sharon2714]

.. and of course u always think of more after u hit submit ....
all three kids PROM with the oldest preemie at 32 wks
no fibroids or endometriosis but a lil intrauterine scarring (possibly from d & c performed for incomplete miscarriage) and vocal chord polyps (benign) removed secondary to the GERD

[Sharon2714]

Well part of my question just got answered ct scan is back ... 2 complex cysts possible neoplasms refer to gyn oncologist in savannah or possibly med university in charleston ... anything else i should look for i woul love to know thanks for ur time
sharon

[Sharon2714]

thanx so much for answering u are my confirmed third opinion LOL

i am printing ur answer for surgical consultation on 7/07

i lift u up in prayer as well ... u are a godsend to this forum

regards
sharon

[Sharon2714]

Thank u for ur responses to my early questions
to follow up:
i am scheduled on 7/23 for my pre op for TAH/BSO
if all goes well it will happen on the 24th at the Hollings Cancer Center, Charleston, SC
i am really very happy as my oldest was born there when she was a preemie :)
baseline CA-125 was 126
my potasium sodium and BUN levels were all low on my blood chem preop work up
they also are doing a chest xray and ekg (due to my being over 40)
Doc said my ovaries combined feel the size of a 20 week pregnancy at this point
and refers to one as softball sized and the other a lemon (i luv the fruit analogy)
and put me on pelvic rest until after the surgery
i also fowarded the contrast medium cat scan and ultrasound cd's to his office
im pretty sure they are being quite thorough and i feel i have an excellent gyn onc
i also get a colonoscopy in two days in case theres stuff in there they have to take
out as well .. i feel young and in relatively good health just so tired ALL the time
but no rest for the weary as i have been an insomniac for 15 years

My Question
what could have possibly thrown the blood chem out of whack ? I never to my knowledge had that happen before. I'll ask him at the pre op i was just wondering ur insights.

LOL i'll let u know how it all comes out :)
Regards
Sharon

[Sharon2714]

btw i met with Dr Matthew Kohler at the consult and he and his team are totally rocking :)
I feel u all who specialize in this field are such dedicated professionals and i appreciate the hard work u do
Best Wishes and Prayers
Sharon

[Sharon2714]

oh and fyi i had two ca-125's drawn two days apart
(the second one was for a second opinion from a gyn)
they both came out exactly the same (126) though they were in two different towns
and by two different labs
i hope that my results help u in ur study of the usefulness of CA-125 testing
after surgery we are moving on to BRCA testing if indicated
then screening my daughters :)
and i will let u know the results of the surgery
i am actually looking foward to it ... i dont care if its cancer or not
i just want it out and to start the recovery process
so ... in addition to my earlier question on the blood chemistry i realized i had one more ...
in your experience is this reaction prevalent among women in my condition ?

[Sharon2714]

another update ... colonoscopy was squeaky clean so to speak
and ... i got mammogram results back and shows changes since baseline
return in 6 months ... i am going to bring those to my gyn/onc as well
and see if there is anyone on staff who can biopsy at same time
its what i like to call one stop shopping

[Annekathryn Goodman, M.D.]

Dear Sharon
thank you for all your updates. You sure do sound like you are in good hands,

BUN is a measure of a breakdown product of protein. We use it as an indirect measure of how a person's kidneys are working.
A low level usually is associated with a low protein level. that can be due to malnutrition or at least a less than optimal dietary  protein intake

A high BUN can be associated with kidney problems or from dehydration.

Low potassium can occur with diarrhea, laxatives, use of diuretic medication.
A low sodium can occur if a person if drinking too much free water and not enough salts.

I hope all goes well with your surgery
best wishes

[Sharon2714]

surgery rescheduled for the 31st
im getting a thoracic ct on monday for "calcified granulomas