Can they know malignant from ultrasound?

[Toobusy1971]

I received my results from a pelvic (transabdominal & endovaginal) ultrasound. A 3 cm complex primarily cystic lesion was detected. In the conclusion, the doctor stated "Complex mass in the left ovary measuring 3 cm. This contains cystic and solid components. The differential includes benign and malignant lesions." My question is, since I know that ultrasound can be very very detailed now, is it truly possible that the doctor was able to tell that the mass is at least partially malignant, or was that an "irresponsible" or incorrect way to phrase it because you cannot tell for FACT if a mass has malignancy by ultrasound alone? If he stated malignant, does that in fact mean that he likely spotted an area that shows signs of definite malignancy? I do have a follow up appt. with a OBGYN/ONC, however they can't get me in for over a week, and of course its making me nuts. If in fact it is likely malignant, fine, I'd just like to know. Not knowing is maddening! Thank you for your help...

[Toobusy1971]

Thank you. I guess I just think if he actually used the word 'malignant' lesions in his conclusion, that he definitely saw something that had all the appearance of a cancerous lesion, or he would not have said malignant...would have just said solid or some other descriptive phrasing...? I will follow up. Thanks.

[Arti Sharma, M.D.]

Hi there!
A vast majority of ovarian cysts are benign. Cysts arising during normal process of ovulation are usually benign and called theca lutein cysts. Excess gonadotropin stimulation can also lead to multiple functional cysts. Malignant cysts can arise from any ovarian cell or tissue. The risk of malignancy generally increases with patient age and the size of a simple cyst. Presence of loculation in the cyst, presence of papillary excrescences which are localized overgrowths of the epithelial lining of a cyst are indirect pointers of malignant ovarian cysts on ultrasound.Endovaginal ultrasound provides more reliable information compared to abdominal ultrasound. It can in few cases do predict about the risk of malignancy if done by an expert ultrasonologist but it can definitely not be confirmed. A family history of ovarian cancers, age and several other factors help in confirming whether a cyst is benign or malignant. Do not panic. Schedule an appointment with an experienced gynecologist. Do write to us again on how you are doing.
Take care!