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Ovarian Teratoma about 10cm, can it be removed by Laparascopy?

yxk
Hi,

I was recently diagnosed with bilaterial ovarial dermoid cysts (or teratoma), the right one measuring 10cm x 6.5cm x 9.5cm, and the left one measuring 7x6x7cm. I am 31 yrs old, single, never married.  My doctors recommends me to remove them as soon as possible through an open surgery, because he thinks it is too large and complex to be done laparoscopicly. I am really struggling to make a decision right now.. I'd really appreciate if you could give me some helpful advice on this:

1.  Should I keep looking for a doctor who is confident to remove my tomors by laparoscopy? If you know of such a good doctor who has a lot of experiences in laparoscopy, could you please let me know or give me some guidance?

2. How do I find a doctor who has experience doing laparoscopy?


3. Should I do the surgery as soon as possible as the current doctor suggested?  The tumors have not been causing me any pain so far, except that I urinate twice as freqently as a normal person does.  But other than that they are not really bothering me.  I am really concerned that the surgery will damage my ovaries, because I want to have children in the future. Would I be better off just leaving them in for now?

Thanks in advance for your help!
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Avatar universal
llbgirl,
I wanted to respond because I am now almost fully recovered from my surgery.  I had a full laparotomy on Oct. 24th.  I didn't know going in if it was endometrosis or a dermoid cysts.  Turns out I had two huge dermoid cysts on each ovary.  I am 29 and was completely terrified going into surgery that this could potentially hurt my chances of having children.  Anyhow, after the surgery there was quite a bit of pain involved as my ab muscles were completely sliced through; however, the doctor pretty much took my entire ovary, cut it open and put it all back together.  He said that after doing so, I will still be able to conceive and that everything looked perfect.  So, I tell you this to put you at ease.  Doctors, especially when they know you are of childbearing age, will do everything possible to save your ovaries.  They can even cut some of it away and it will still release an egg!  Pretty amazing.  Anyhow, I would be glad to shed some light on this surgery.  I, too, was so worried about cancer....you think the absolute worst in these situations even when you are told not to worry!  Hang in there and keep me posted.
Helpful - 1
Avatar universal
I was diagnosed, about a week ago, with a 10cm cyst on my left ovary (only one I have left because of a hysterectomy..)(kept one for no hormone therapy)and I was having pain.  My doctor also suggested "open" surgery because of it's size.  He wasn't sure what, if anything else may be going on, the ultrasound showed it at 10cm but he didn't know if it was twisting the ovary etc. and if anything else was up he couldn't do anything for me by doing it laproscopically. (had many of those over the years also.) If I were you I would definitely do the open surgery and yes as soon as you can.  Not that anything else will be wrong, but it could be and your doctor would be able to do whatever he could for you to enable you to have children down the road. Also by doing it soon you are not giving it the chance to do much more damage.
   To try to make a long story short, I had many "female problems" over the years, resulting in an almost complete (if that makes any sense) hysterectomy.  I didn't want any more children and I was so tired of the many things going on..and the endless waiting to find out what my next test results were going to be.  I think that was the hardest part, the waiting and not knowing.  Anyway, after that I haven't had too many "female problems" to speak of.  Small cycts basically that would be absorbed naturally until last week.  I don't know how something that size doesn't cause pain until it did but it did.  Anyway, longer story longer...had open surgery for this 10cm cyst last Thursday with the possibility of losing the ovary because they couldn't tell if the cyst was attached or twisting it.  I asked them to do their best in keeping the ovary as I'm 43 and still do not want hormone therapy but I knew they may have to.  When the doctor went in he found so much going on that there's no way he could have done anything or fixed anything else had we done it laproscopically!  The cyst ended up being 10cm by 20cm!  A small football! It was attaching to my urethra (sp?), pushing on my kidney/gall bladder, I had a ton of scar tissue from previous surgeries and it had caused my bowels/intestines to become "bunched" up and adhering to each other in a ball.  The doctor was amazed and amazing!  Said he took out quiet a few of my organs, cleaned me all out, removed the cyst and put it all back the way it was supposed to be.  He said I will probably feel better than I have in a very long time.  It will take time I know but I have to say, even though I'm only a few days into my recovery I do feel better in many ways.  I'm not telling you all of this to scare you as everyone is different and since you don't have pain yet I don't think you're situation is quiet like mine.  I am telling you only so you know what can go on and if I didn't have it done right away I can only imagine what else could have happened.  I do think that recovery is part a mental thing also..I think that has alot to do with alot of things (had brain surgery 10 years ago...another long but successful story, but without the strong mental health and drive I'm not sure that would have gone totally the way it did).  By the way  I STILL HAVE MY OVARY!!
   Do yourself a favor.  If you feel more comfortable getting a second or third opinion do so.  I do suggest a few things though..If the second opinion is nothing like the first definitely get a third and then compare all the doctor's notes.  If you trust your doctor then the other opinions may not be neccessary.  But be sure your doctor knows your future plans, kids etc.  Also if the end result is to have surgery then I suggest you do so and do it soon so as not to complicate anything else.
   I wish you the best.  You'll be in my thoughts and prayers and please keep me posted as to your outcome!  Sandy
  
Helpful - 1
Avatar universal
Hey,
I know how you feel especially being so young. Dont be scared. I had a teratoma on my right ovary when I was 25 but unfortunately it was so big they had to totally remove my right ovary. But the odd thing was the pain was on my left side. The doc said the tumor was so big it had numbed my right ovary so I didnt feel the pain there but I guess I had to feel it somewhere. Then when I was 30 I had a total hysterectomy due to a tumor but not a teratoma. I am now 38 and have not had any complications since. Dont be scared. Just remember what I said I thought it was my left ovary where the pain was so bad but the teratoma was on my right ovary. So dont worry. Take care
    
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447161 tn?1262923084
Hi there,

I am new to this site but the women here will answer your questions.  It is possible to have cysts on both ovaries at the same time.  A very high percentage of cysts are benign so try not to be scared and just become the best informed that you can.
Good Luck and try to cheer up.

Regards
Kim  

Helpful - 0
Avatar universal
I've been searching the web about what a teratoma is and I came across this.  I am 21 years old and just getting ready to graduate college in a month when on easter I had unbearable pains in my lower abdomin.  After going to the nurse practitioner at my hospital she gave me two options.  I go either to another doctor or the ER.  Since I seem to always contract the weirdest illnesses she thought I needed another doctors opinion because it appeared to her I had an appenditis.  The doctor thought the same and had me sent for a CT scan.  Luckily the scan said I was in the clear and I was prescribed some medication for the infection my body seemed to be fighting.

The next day I got a call from the doctor telling me I must come in next week to discuss my CT scan and that she could explain it to me over the phone.  To my surprise, I have a teratoma 6.5 cm on my left ovary.  From reading all of these posts I am wondering if I have another teratoma on my right ovary which is where more of the pain is.  I refused the IV with iodine during the CT scan because I was so naseous I just didn't want to be pricked with more needles.  SO my question to you ladies is:
Is it possible I have another teratoma on my other ovary?  
How long can I wait to have the surgery?
At what size do they no longer do the surgery laparascopically?
If it is removed using laparacopy how long is the recovery?

I am scared and so upset.  I am graduating and I won't have health insurance and I just thought I would be entering the real world excitedly to start some type of career.  Also, I have had two knee surgeries I really do not need any more scares.  I hope some of you ladies can give me some comforting advice for finding this out when you away from home sick in pain and suppose to be graduating is very depressing.  I need some cheering up!
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Avatar universal
By the way, the scar is nothing on me.  I believe it is about 3 1/2 inches and right in my bikini line.  The one in my belly button is like a scratch (they started there and then did the full laparotomy).  I will be going back to work after next week which will make it 5 weeks after surgery.  Hope that helps.
Helpful - 0
Avatar universal
Hi everyone,

I had to respond, because I'm dealing with a lot of the same concerns as you ladies.

I was diagnosed with Polycystic Ovarian Syndrome when I was 13.  I'm 27 now. I went to the hospital one morning about 2 weeks ago after getting constant abdominal pain that lasted over 11 hours. After getting an abdominal & pelvic ultrasound, I found out that I have two large cysts (one is 12x7 cm, and the other is 7x5 cm). The big one is on my right ovary and there's some evidence of torsion. The smaller one is on my left ovary. To make matters worse, I also have gallstones and an as-yet undiagnosed "mass" on my liver (all they know is that it isn't a fatty deposit).  

I was tested for ovarian cancer and thank God, it came back clear.

I'm going to see an OB-GYN this week to discuss surgery. I'm pretty sure I'm going to have to do open surgery as well - laproscopy isn't going to cut it (pardon the pun) for cysts of this size, especially the one on the right. While I'm dealing with the ovarian cysts, we're going to get the gallbladder out in the same surgical procedure.  One stop shopping!

I have to admit, I'm terrified. I'm especially scared of losing my ovary or ovaries.  I'm also worried about the dreaded scar and of losing my job over the extended medical leave.

Can somebody please shed some light on:
- how big the scar is;
- how long the surgery lasts;
- how painful the recovery is; and
- how long it'll be before I can return to work (I'm a lawyer, so my work is primarily desk-bound with the occasional trip to court)

Thanks so much ladies. It's nice not to feel so alone. I'll be checking for your responses.  Bye!
Helpful - 0
Avatar universal
What a coincidence that you gals are going through this right now, and I just got diagnosed.  Friday at noon I experienced some crazy pain in my left lower abdomen.  I have my yearly gyn physical scheduled for Monday am anyway, so I thought I'd wait it out.  Oh my gosh, the pain radiated to my left armpit that night and after 24 hours, I had to go to the ER.  

A CT scan showed a 10 cm teratoma on my left ovary and a 3 cm on my right.  The ER doctor had no idea why I had pain in my left armpit.  I found out through a doctor friend later, that my left teratoma has probably leaked fluid, and when I lie down the fluid is going to my chest and causing pain.  It should reabsorb, but it hasn't yet.  I'm sleeping in the upright position.  The ER doc gave me morphine and Dilaudid.  Both made my head spin, but neither helped my chest pain much.

So I'm back home with my hydrocodones, just waiting for the constipation to kick in.  I've had surgeries before and this always seems to happen with that med.

Anyway, I've heard stories now that I'll be in the hospital 5-6 days, and off my feet for up to 6 weeks.  That's crazy.  But at the same time, I know of 3 women who felt much better and didn't rest like they should and wound up having their bladders collapse and had to have more surgery to tack it in place.

The ER doc said I may lose my ovaries, and that could mean I may have to have a hysterectomy.  I'm thrilled to see that some of you have been able to keep your ovaries.  I'm 38 and don't plan on any more kids, but am not quite ready for hormone replacement therapy yet.

Also, I'd like to have it done laporoscopically also.  There seems to be conflicting views on this with a tumor 10 cms large.  Wondering what my doc will say tomorrow.

For those of you recovering, I'm imaging you feel much better now than you did prior to surgery if you had pain?  I can't function with this amount of pain.  I'm thinking post-op has got to be a breeze.

One final thing, I'm supposed to give a baby shower in exactly 2 weeks.  I called the friend yesterday to try to ease out of it, and hope she could transfer it to someone else's house.  She said we should just wait till I've had my surgery and see how I feel.  Shouldn't I just tell her no now?  I can't imagine I'll feel like hosting a baby shower for 30+ people in 2 weeks.
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Avatar universal
Hello All:

I had to respond since I was up and I just had a laporotomy on Saturday October 22. They removed one Ovary to take out a cyst that was about 10 cm. I completely understand being nervous although I was just determined to get it overwith. It is not as bad as I thought it would be. It's not a picnic but truely I already feel better knowing the tumor is gone and that I am ultimately healthier. The hospital really helped me to get better fast, they got me up and walking around which helped a lot. I saw no blood:) I am very bruised at this point and my belly button is sore. I should be back at work and miss two-three weeks, I'm thinking two. Driving is a no no and you do want someone there but I am alone during the day. I was at the Hosp for two nights and then they let me out. Your middle hurts but if you keep a pillow on it for some pressure it helps. I agree this procedure is better than a scope you really want the mass removed whole you don't want it broken in case it is something bad. My only worry now is the results. The bathroon is a bit of a challenge too:) All together I'm ok and you will be too. My best wishes are with all of you! Beth
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Avatar universal
I can't help but respond to your posts.  I, too, live in New Jersey and was just on doing some research about the procedure I am having on Monday.  My doctor is Dr. Stewart in Branchburg.  Anyhow, I am so nervous b/c I don't know what to expect as far as pain is concerned.  I am engaged and only 29.  My problem started with a pain in my bladder and after infection was ruled out, a ultrasound showed some very large masses.  The doctor thinks it could be dermoid or endometriosis.  He doesn't know for sure.  Anyhow, any advice about the full laparascopy (cut in abdomen) would be appreciated.
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Avatar universal
yxk
Dear Sandy,

Thank you so much for the helpful information.. I've called and made appointment with Dr. John Fetz, on November 1st, which is the ealiest one the nurse said she could give me. It seems the waiting time is more painful than the thing itself. I started having nightmares about bloody sugeries these days and I had a car accident today on my way back from the ultrasound place.. Feel very depressed right now.. will write more tomorrow when I try to calm down.. Thanks so much
--yxk
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Avatar universal
You just gave me chills!  I so much believe that God works through us in so many ways.  I have absolutely no problem giving you the doctors names etc.  The funniest thing is that the second dr. I found here in Ocean County was first recomended to me through my aunt whom is a nurse and well long story short, seems I've got alot of those don't I??!! hahaha The drs group here in Ocean County works through the same I guess you'd call it "service" that my original doctor is with!  As soon as I heard that I knew I'd found the right one here!  First of all the group is:  Women's Health Care.
My doctor in Morris County (the one I had for 18yrs) is Dr. John Feltz.  He is on Madison Ave in Morristown.  He works out of Morristown Memorial Hospital.  I started with him before he even had his own 'real' office, now he has about 6 to 10 other doctors with him..all of whom are good.  I always asked for him however.  I have seen Dr. Ferrante and Dr Locatelli also.  The phone number there is 973-285-0400.  If need be, speak to his wife Donna or his one nurse Ginny.  Tell them that Sandy Maraguglio recommended you call them and explain your situation.  These two woman know me very well and have also been with Dr. Feltz forever (Donna started out as his secretary!)
   The second doctor I would recommend is here in Ocean County.  His name is Dr. George Trim.  They are located on Route 72 in Manahawkin.  His number is 609-978-9870.  I called them on a Tuesday, had an appointment on Wednesday and had my surgery on Thursday.  (I pretty much knew what was going to be the outcome before I walked in so...)  I can't say I've been with him long, but I can tell you how I felt the moment I walked into his office (his staff was great, pleasant, caring and very understanding of my fear..) and that day Dr. Trim first took me in his office, we talked, then went to an exam room where he did a very short and not a very painful internal (I'm not sure if you've had to go through that recently, but I don't wish it on my worst enemy!!)  Dr Trim was soooooo gently and tried to be so quick and he made it, well as nice as it could be anyway, hardly any pain at all actually.  Then he came back to the room and spent more time with my husband and me explaining etc.  Then the day of surgery...I don't need to go throught all of this...just know that I am VERY picky when it comes to OB-GYN because of all that I've gone through and even though my relationship with Dr. Trim has been a brief one I am SO VERY HAPPY with him and I will continue to go to him!!
   I hope one of these doctor's are near you.  I really think if you are able to see them you will feel very comfortable with whatever it is that needs to be done and also that they took the time to listen to your needs/concerns/fears.  I really think you'll like them as much as I do!  If I can help you out in any other way please do not hesitate to let me know.  I'll do anything I can.  Good Luck and Keep me posted!!  Sandy
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Avatar universal
yxk
Dear Sandy,

Thanks so much for your kind words and prayers.. They really meant a lot to me.  The amazing this is that I live in New Jersey too! I think our God do listen to our prayers and he is guiding me right now through your generous help. I'd really appreciate if you could give me the phone numbers of your doctors that you'd like to refer me to.  Please let me know If you need my email address or phone number. I very grateful that you are willing to help me, because I am so helpless right now and I don't really have many friends in this country that I can  talk to about such personal stuff.. Which makes things very tough for me. Thanks very much Sandy. I hope to hear from you soon

--yxk
Helpful - 0
Avatar universal
yxk,
  Where are you living at the moment?  I'm in New Jersey, if that helps and actually I have two drs. that I would recommend, one in Morris County and one in Ocean County.  If this is at all possible for you, let me know.  I will get you there names and numbers asap.  I was with the one dr. in Morris County for 18 years and then decided to move.  Ifound him because of an emergency (ruptured cyst, internal bleeding) and swore I'd never leave him.  I would follow him to the ends of the earth if I had too!!  Then I came to South Jersey and well never had a need to find anyone else until last week, again, another emergency, so to say..My dr. was away on a family emergency so...and from the minute I walked into the dr who did my surgery's office, well...his staff was super and then he was too!  
  If you aren't anywhere near NJ I would suggest you do what I did, and then some, if you need to.  I called family and friends for recommendations.  I know you said your family isn't nearby so rely on friends.  Ask the women you work with.  Ask how long they've been with them?  What type of situations/conditions they've gone through with the dr? And the one thing that is real important to me, but maybe not you, is how did the dr treat them when they had any concerns or questions or problems.  I need a dr who takes their time..doesn't rush me out of their office like we're herds of cattle (because they have a schedule) or not call me back after hours when I call and say I really would like to talk to the dr personally.  You need to be sure to ask around to friends and co workers, but ask questions that are important to you.
  I understand what you're saying about the scare thing.  I have to say I haven't been too please with having one even though I've got the kids etc.  BUT you can include that in your concerns with your doctor and tell him how you feel.  Ask him to try and cut lower or stitch it smaller or whatever...For this past surgery, I didn't talk to my dr about it, but I did my husband.  I was like, I don't want another scar like this and then a roll of fat and blah, blah...(just want to shorten convo) anyway the day the dr. took the dressing off (this past Sat.) my husband said "Honey, he cut on the same scar!!"  I was shocked!  I didn't say a word to him yet he knew my concerns!  My reaction was...You know women and their vainity don't you?  All I'm trying to say is don't get yourself so crazy about what you may look like that you put your health in jeapordy.  Talk to the doctor!!  That is the MOST important thing!  You need to feel comfortable with him/her that they know what they are doing but they are also trying their best to keep your wishes (so to say)  Know what I mean?
   Please talk to people to get a good doctor, but you need to get one who is good for YOU.  I'm not sure how your friend in CA got to have a cyst removed lap..especially of that size, but you've seen 2 doctors and both have told you the same thing.  And I know we've told you what we have had to do.  I'm not saying you should stop trying to find doctors nor am I saying that what we're telling you here is gospel, but.......I guess all I'm trying to say is Please don't sacrifice your health for beauty.  I know you're young and I'm sure you've heard it a thousand times...if the guy doesn't love you for what's on the inside then he's not worth it...well it's true!  (another long story but was married 18yrs. was told if I gained weight, "other than for medical reasons" we'd be getting divorced...alot of other things in between, but I did gain weight and it WAS for medical reasons and we got divorced)  So please don't put your health in jeopardy for some guy!!  They are so not worth it, if they're going to be so shallow!!!
   I've made this so much longer than I should have, but I'm praying that something here has made sense to you, it's so important.  I know it's hard when you're family is so far also.  Know that prayers are going your way...Every one of those helps!!  Keep me posted and good luck..Let me know if you want those names/numbers I'll get them right to you...Sandy
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Avatar universal
yxk
Dear sandymom and angellei,

Thanks so much for for sharing the detailed information.. Really appreciated.  Also Thank you so much for your prayers.

Actually I just saw another doctor, but he also didn't feel comfortable removing my tumors by laparascopy and suggested that I do the open surgery.  I was very upset. I am worried that the long medical leave incurred by the open surgery will affect my job. Also, I really don't want a big scar on my abs, because I don't even have a boyfriend right now and I don't want to make things worse.., and all my family lives overseas, meaning there will be no one to take care of my after the surgery.  Also I am still not confident that I've found the right doctor who has experiences in laparascopy.. because my friend in Califorina was able to get hers (of similar large size) removed by laparascopy sucessfully.

I know I am being unreasonable and stubborn on this.. But even if I am going to do the open surgery, I'd really appreciate if
you could let me know how I go about doing research in finding the best possible doctor? I don't know many people in this country and all I've been mostly relying on the internet.

Thanks so much for your patience and help...
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Avatar universal
I had a dermoid tumor, but just one. it was 11CM. I think your dcrs are right because you CAN NOT take it out laprascopically. It has to be a laparotomy. It is too big. Good luck, if you have any quiestions about my experience ask away. I am now on week 6 of my recovery from my surgery.
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