Complex ovarian mass

[Karina66]

Am told I have a complex mass on left ovary with both solid and cystic components.  Any idea what this means?  Possibility of cancer??  Hysterectomy?? Laparoscopy??  Help!!!

[chelan3]

What did your gyn say?  Likely you should still see a gyn-onc as they can't rule out cancer until the complex mass has gone through pathology.  It's actually on the smaller side - I wouldn't be surprised if your gyn recommends a watch and see approach.  But if you're concerned a second opinion from a gyn-onc might be beneficial.  
Let us know how you make out.

[Karina66]

I got ahold of the ultrasound report:

PELVIC ULTRASOUND:
HISTORY:  Pelvic pain
Transabdominal and transvaginal studies were performed.

The uterus measures 10.4 x 4.9 x 6.0 cm.  Endometrial echo thickness is 7-8 mm.  A few cystic areas are present within the endometrium.  There is a history of ablation one year ago.

The right ovary is measured at 2.9 x 1.6 x 2.4 cm.  The left ovary is 3.9 x 3.5 x 3.4 cm.

Within the left ovary there is a complex mass with cystic and sold elements about 3mm in diameter.  Etiology of this  is uncertain.  Blood flow was demonstrated to the left ovary.

No other abnormality can be identified.

IMPRESSION:
1.  Complex mass with cystic and solid elements left ovary.  Both benign and malignant etiologies are possible.
2.  Small areas of cystic change within the endometrium.
3.  No other abnormality identified.

**I can see that the left ovary is much bigger than the right.  Not sure what blood flow to the mass has to do with anything.  I read under the Impression section that the root for the mass could be either benign or malignant.

Any ideas or guidance??

[chelan3]

No, don't do a scope, as diana mentioned if it is cancer you have one chance to get it right the first time.  Now, that being said you could discuss doing a scope and if it doesn't look good give them the option of doing the full laprotomy.  That's what they did with me. The complex cyst was wrapped in my fallopian tube though and that's the reason I had full laprotomy.  

[Karina66]

Also - I am 41 yrs old and had endometrial ablation surgery 1-1/2 years ago, so no more periods but have all the original parts.  Not close to menopause.  If pathology results will tell more, how will that happen - like a scope surgery just to check it out and take a sample?  

[Karina66]

Thanks for the feedback!!  The cyst doesn't concern me, as I've had them before and had them removed via laparoscopy - but the solid mass was the phrase that got me worried.  I do not know the size yet - will find out next week at my gyn appointment.  I definitely hear you all loud and clear, though, about the gyn oncol if necessary.  I appreciate that!  

[dian07]

Hey there.....slow down a little bit....take a deep breath and don't panic until you have reason to!  How big is your cyst.....most gyn/oncologists don't remove them until they are at least 5 cm or they look really suspicious.  My guess would be that it will be removed since it is solid but they might want to wait a little bit to see if it resolves on it's own.....maybe not....maybe they will want to remove it now.....wait and see.  A laparoscopy is possible depending on size .....a hysterectomy would be done only if necessary.  I will remind you that 98 - 99% of ovarian cysts are NOT cancer....don't waste a good panic ......cancer cannot be determined until a biopsy is sent to pathology during surgery.....at that time it is determined what needs to be removed.  If surgery is in the cards...YOU HAVE ONLY ONE CHANCE TO GET IT RIGHT THE FIRST TIME....make certain you have a GYN/ONCOLOGIST perform your surgery....this is their area of expertise.  But....you are way ahead of yourself here.....like I said at first....take a deep breath and lets find out what is going on.....hang in there and stay in touch.
Peace.
dian

[chelan3]

Hi Karina, I know how confused and scared you must be.  When a women is diagnosed with a complex mass she should see a specialist - a gynologist oncologist.  They are experts at dealing with complex masses.  Many are benign.  How large is the complex mass?  Are you already in menapause?  My dr told me anything over 5cm should come out but he did offer me a wait and see approach (I still had periods - was in my 30's).  I didn't want to wait.  If you're already in menapause it is more suspicious for cancer.  I asked my doctor for all my records - ultrasound, blood work.  
Again, you should see a gyn-onc they can recommend what approach you should take.  No one will know for sure if it's cancer until you get results from the pathologist.  Even after opening me up the dr's didn't think I had cancer but the frozen section pathology (they take a quick sample while your in surgery) determined I had a LMP borderline ovarian cancer.  I was very lucky.  
Don't get too worried though, ovarian cancer is rare, but see a gyn-onc for advise.
Good Luck.,
Let us know how you make out.