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How likely is it that my complex ovarian cyst is cancer?

I have a uterus with large fibroids which cause horrific periods every 25 to 27 day cycles. Very regular on my cycles. Never miss a period. I have annual ultrasounds, and the one in June, 2016 showed an enlarged uterus, two large fibroids, but the ovaries were normal. I have been experiencing constant lower back pain and lower abdominal pain for years now. This last year, it got worse. The last month it was constant, and I lived on ibuprofen which stopped helping and a heating pad. I got my period a couple of days ago (26 day cycle) and this time the blood loss was horrendous and I had snap abdominal pain. Went to the ER. They Did an ultrasound both transvaginal and regular. The findings showed an enlarged uterus with multiple fibroids and a thick lining. However, it also showed my left ovary enlarged with a complex cyst measuring 3.4x1.7 by 1.6. The right ovary is normal. It also states there is vascular flow seen within bilateral ovaries and no free fluid. I had sharp stabbing pains in my pelvic area while n the ER, low grade fever and slightly elevated white cell blood count. I am 48, almost 49, and scared out of my mind. I was also shown to have anemia, even though iron was high as I take iron supplements for the horrific periods. I am BRACA and Lynch Syndrome negative. Do have Breast cancer and pancreatic cancer on mom's side of family, although no personal history of cancer so far. Seeing my gyno tomorrow, but scared about the cyst. It formed within the past 11 months, as not visible on ultrasound from June 2016. Also, uterine biopsy was negative last year. What are the chances I got overian cancer? I was never pregnant. I never took hormones. I have been battling fibroids since my 30s and had a maymectomy over a scare ago. The fibroids returned with a vengeance, and I am ready to do a hysterectomy, because I have no life quality with the horrific bleeding every 25 days on average, and the constant pelvic and lower back pain that now has been going on for more than a year. But, I was hoping to keep the ovaries, and have a partial hysterectomy. Now, with this complex ovarian cyst, I think I will need full hysterectomy, and I am pat rifled of cancer.
3 Responses
134578 tn?1614729226
I guess I'd ask the doc a couple of things, or would ask for a referral to a specialist.  My first question is why did you never have an MRI of your uterus and ovaries?  Ultrasounds only show so much.  It makes me think you have been getting only ho-hum medical treatment.

And the other question would be, if the ob says you need to have your uterus removed to get rid of the painful cycles and to remove the ovary in order to get rid of the complex cyst (I would of course ask if the cyst can be removed without removing the ovary), anyway if it looks like you need to lose the ovary and the uterus, it doesn't sound like you need to lose the other ovary.  If this doctor shrugs that off and says "it will go anyway after your uterus goes," seek a reproductive endocrinologist for a second opinion.
Thank you for your reply. Will follow your suggestions. But, what are the chances that this complex cyst is malignant? I pray that it is benign and that I can keep at least one ovary, but if they find cancer, then everything will be removed. I keep reading about complex cysts and some sources are very optimistic, and others are less so. Very fearful about the odds.
I I was always told that all the pelvic pain and lower back pain I am constantly in is a direct result of the large fibroids and enlarged uterus pressing on nerves and other adjacent organs, like bladder, as I wake up constantly during the night to go urinate. I saw four separate specialists late summer of 2016 under a good PPO coverage, and they all recommended hysterectomy or watch and wait based on my ultrasound fibroid findings. Nobody suggested MRI, Catscan or any other test, except genetic testing which I did do for BRACA and which was negative.  When I asked if I might have endo or scar tissue from the prior maymectomy, and that what was causing the pain, I never got a clear response. My bleeding was much more contained in October of 2016, when I saw my gynecologist last, she did the uterine biopsy which came back negative and I was not anemic back in October. So, I decided to postpone hysterectomy and try to stretch it through menapouse  without surgery. But, since then, pain became much worse, and so did the bleeding. I honestly think it had to do with this complex overian cyst which was either not there back in June, 2016 or too small to pick up on. I will ask doctor tomorrow about MRI, about what do the actual Ultrasound pictures show, as the description in the written report is very limited, about ca-125, and about the timeline. I read time and again on these forums, that many times gynecologists know how bad things are from looking at the ultrasound images. The ER Doctor was a joke. He did not even tell me about the enlarged overy and the complex cyst. Did not even touch on it. He told me I need to eat less sugar as my blood sugar test came back slightly outside norm range, but I was not fasting. I am about 30 pounds overweight and he chose to really lay it on me about my blood sugar and my ALT liver enzyme being elevated (probably from all the iboprofane and iron supplements my liver had to digest). When I mentioned the ovary, he said that is not your problem now, but follow with your gynecologist. Really? Not my problem? I showed up flooding the ER with my blood and severe pelvic pain, but the ovary and the complex cyst were not even mentioned. I kept asking the ultrasound technician, the nurse, the doctor if the ultrasound showed anything bad besides the fibroids, and they all kept saying, all else was normal. They either lied on purpose to let my gynecologist deal with it, or just did not care. The ER Doctor was not a gynecologist. They did not have one on call. I went to that specific ER because my gonocologist is affiliated with them, but they sucked. My questions to anyone reading are as follows, what are the chances this complex cyst is benign? If it states vesicular flow is present within the ovary does that mean they did  a doffler ultrasound and know there is blood flow to the cyst? Does that make it worse? There is no mention of sepiations or other description of the cyst except the location, size and that it is complex. There is no further suggestions that the radiologists made with respect to cyst. I am just patrified. I know the ovaries are very important to a woman's health, but if this is malignant, they will take everything out. I am also concerned about scar tissue from the previous mymectomy which was ten years back, that I have endo, and that I really need to find a good oncological  gynecological surgeon to do my surgery.  Shell shocked. All my life issues with uterine fibroids, but never ovaries.
134578 tn?1614729226
I don't associate fibroids in the uterus with complex cysts in the ovary, meaning if I were you I would think these two things are unrelated, and you just got unlucky.  A friend of mine had a very messed-up uterus, with I don't know what and adhesions reaching elsewhere into her abdomen and a lotta lotta pain in the lower back.  But it was not cancer.  In short, the uterus can have a lot going on without it being because of having a cancer, and also without the ovary being the cause.  I will say, of course an ovarian cyst will hurt.  It's possible you have a lot of scar tissue in the general area, too, and that can pull and hurt.  

But I think you need to talk to your ob-gyn and not take advice on the Internet.  You are totally within your rights to insist (and go so far as to put it in writing) that even if they decide to remove the one ovary, they not go after the other  just because you are knocked out and 48 and they just may as well because they are there.  There is no rule that one ovary coming out automatically means the other has to, especially without any kind of biopsy or bloodwork or anything that indicates a positive finding of cancer.  Get it through your doc's head that you want to be certain removing the other ovary is necessary, you don't want them to be casual about it.
Thank you for your thoughts and comments, AnnieBrooke. I agree that seeking advise on line is not very helpful, and will be seeing my gynecologist today. Will bring up all if my concerns with her. Thank you again for taking the time to reply.
Avatar universal
Wanting to know the same thing....have you had any updates?
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