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Prominent Endometrium and Complex Ovarian Cyst. Help?

Hello everyone.  A little history...I'm 40 years old, with one pregnancy and birth.  I've had some mild pelvic pain with frequent urination off and on for the last few years.  My periods have become quite heavy with an increase in cramping that shoots through lower back and down my thighs.  No bleeding between periods.  HPV has always been negative.  

I'm also experiencing intermittent lower back pain that is new to me.  I have a history of IBS, which makes pelvic discomfort confusing, as there can be quite a bit of pain during flare-ups, so it's possible that some of my gastro issues are of dubious cause?

Transvag ultrasound 2 years ago showed nothing of interest.  Since the symptoms recently increased and I was sent for another.  This time, the findings were less comforting:

-Prominent endometrium (14.5mm) with somwhat inhomogeneous internal echogenicity

-No free fluid in cul-de-sac (not sure if this is good, bad or indifferent as it pertains to the other findings)

-Right ovary measures 4.1 x 2.3 x 3.1 cm and contains a complex, possibly resolving cyst measuring 2.6 x 2.2 x 1.7 cm.

It was my PCP who ordered the ultrasound and I haven't seen an ob/gyn yet (my previous dr. moved out of state and I've been looking for a new one...but every one that's been recommended has not been taking new non-maternity patients).  I'm about a year and a half overdue for my usual pap smear/exam.  My PCP's office has given me a name, but their office was closed, so I will have to wait until Monday to attempt to make an appointment.  As you may imagine, I'm coming out of skin.  

I know that self-diagnosis over the internet is a dangerous thing, but I couldn't help myself.  Needless to say, nothing good came out of my investigations and I'm quite frightened.

Does anyone have any helpful information or suggestions?  I would so appreciate any and all responses.  Thank you.
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1242509 tn?1279124464
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. **********
Since there is some suspicion i.e; complex cyst  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. ######
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.
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