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Ovarian Neoplasm Found


I am 46 years old and I do not know my medical history.  A neoplasm has been found on my left ovary, and is infiltrated with fluid.  The mass is about 5 cm.  This was found on transvaginal ultrasound.  The Dr. wants to schedule me for a laparoscopy.  The CA125 came back within normal range.  she says that the mass is funny looking and the ovary needs to come out.  She intends on removing both ovaries and leaving the uterus (if the endometrial biospsy comes back normal).

I have left hip pain that does not go away, and I cannot sleep on my left side.  I have had menstrual problems since my 20's and have been on and off SSRIs to regulate PMS symptoms.

My concern is whether or not I should have a laparotomy or laparoscopy.  My Dr. says that while in surgery she can send out cells to be analyzed and if it is cancer we can abort the laparoscopy.

Does the CA 125 being normal mean that it is not cancer?
Should I seek a second opinion?
Should I have the laparoscopy and then deal with the laparotomy if it is cancer?

I appreciate your time.
2 Responses
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242604 tn?1328121225
Dear Bella,

The first important decision is whether a person needs surgery or not. As most ovarian cysts are functional - that is related to the menstrual cycle - they will go away after a few menstrual cycles.

For cysts that do not, go away, are greater than 4-5 cm, are causing pain, are associated with other finding (elevated CA 125, fluid in the abdominal, other tumors, etc) , look complex with both solid and cystic parts, and so on - surgical removal is the next step.

Once deciding that surgery is the next step, how to do it and whom should be the surgeon is the next set of questions.

That is a little harder to sort out without further information such as:
-physical exam findings,
history of previous surgery
history of previous cancers
family history of cancer
-the actual report of the xray

all these factors are important in deciding the how and whom questions.

Most cysts are being. Ca 125 is not always useful as Katie says.
It is reasonable to start with a laparoscopy and look and make the technical decision as to scope or lap at the time of surgery.  You should ask your doctor whether a gyn oncologist should get involved. She can let you know if you have risk factors that warrant a referral.
please let us know what happens
take care
Helpful - 1
Avatar universal
My opinion is that you should be looking at a lapartomy and seeing a gynecologic oncologist. The CA-125 does not mean anything either way.  It is great post diagnosis but not great pre-diagnosis. The endometrial biopsy will have nothing to do with ovarian cancer unless the ovarian cancer is advanced.  Even if it is normal, that doesn't mean the ovarian masses are ok.  
Helpful - 1

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