3cm Septated Complex Ovarian Cyst

[DHG1031]

Over a month ago, I had a visit to the ER for excruciating pain on my right side, in the back and pelvic area.  I had a CT done, which showed a significant amount of free fluid in my pelvic area and a kidney stone.  They also did a ultrasound, which found a 3cm septated complex cyst on my right ovary.  They sent me home with some pain med and said it would subside within 72 hours.  I scheduled a follow up appointment with my OBGYN and he said that it is probably nothing to worry about and that it should resolve itself after a few menstrual cycles.  Well, I've had one cycle and I am still very uncomfortable.  I have a lot of pain in my lower back and legs and pressure in my pelvic area.  Simply put, I am not menstruating, but still feel like I have all the regular symptoms I have when I am.  I am having migraine headaches, I am overly emotional and irritable and all of this pain is very uncomfortable.   I went back to the OBGYN and again, they said that they can tell that my ovary is still enlarged and that I most likely have the cyst still.  They want me to wait another cycle and have another ultrasound next month.  If the cyst is still there, they will perform a lap surgery. They have said that all of these symptoms are due to the cyst.  I am a 32 year old with one child.  I am wondering if anyone else has had the same type of experience.  My husand thinks it might be wise to get a second opinion.  I am not sure if I can hold off another month with all of these symptoms.  Any information is very much appreciated.  Thanks so much.

[kcd86]

Based on the first MRI we were told it was a fibroid but based on the sonogram it did not sit well with me so I called DR Carol Brown's office from Sloan Kettering she is an excellent GYN/Oncologoist. Dr Brown repeated the MRI and was read correctly by the radiologist oncologist. She was menopausal so she started to bleed and the mass was discovered on exam. Her type of OVCA is not related to the CA-125 so it was negative but her Inhibin was high. If you are in menopause then you should have no or very little Inhibin levels. If you need a refferal for your insurance than get it from your gyn if not just call the gyn/onc you are going to see. As I said in my post I would go to a large medical center where their GYN/Onc service see alot of patients
All the best
Kevin

[DHG1031]

Thanks so much for this information.  I feel like I am very tuned into my body and something is just telling me that its not right.  I am going to heed your advise.  Did your wife get diagnosed with fibroids only or was there something else going on?  Did the doctors run the CA125 and other tests because of this diagnosis or did they do all of this at Sloan Kettering?  Did she have any similar symptoms to those I've listed?  How do you go about getting a refferal to see a GYN/ONC?  Does that come from your general practicioner or do you have to get it from the OBGYN?

[kcd86]

I am sorry you have to go threw this it is very stressfull to have this hanging over your head. Keep in mind most cysts are benign!!  
My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 and I know what it feels like to not know what the next step is. Here is a quick overview.

Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx).
The blood test CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other causes of inflamation..
There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS. Please keep in mind if and only if you have a dx of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing tumors as opposed to epitheal.
Unfortunately with any type of suspected ovarian mass/tumor/ suspicious cyst(s) surgery will be the only way for the Dr's too make a definitive Dx.
*****It is NOT recommended to biopsy any ovarian mass/tumor/suspicious cyst as it can rupture and seed the pelvis with cancer cells if that what it turns out to be. **********
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Since there is some suspicion  I would immediately find a good GYN/Oncologist surgeon. I am not suggesting what you have is cancer but studies have shown that treatment of ovarian cancer by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients.  This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure #####PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal. ######
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Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a **Radiologist that specializes in GYN/ONC**, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC(specializes in cancer only) to see a GYN/ONC surgeon who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best.
Kevin