6 cm cyst containing or next to a smaller one

[JANEB58]

For the past few months, I have been suffering general symptoms now seen as possibly indicative of ovarian cancer -- bloating, mild urinary incontinence, abdominal pain, feeling full quickly, etc.  I finally went to by internist who ordered transvaginal and abdominal ultrasounds.  They disclosed a "6 cm ovarian cyst, which contained a smaller cyst [2.3 cm?] inside" [or possibly next to it - 2 different messages].  I came home from a business trip to a phone call and a letter providing these findings, but missed my doctor and won't be able to talk to her until Monday.  I have a friend recently diagnosed with ovarian cancer, so am assuming that a C-125 test should probably come next as well as a visit to a oncological gynecologist.  But, what I would like to know in order to survive the weekend, is what the presence of the cysts likely means.  How frequently are they malignant vs. benign?  Is 6 cm considered small (i.e., an early discovery) or large, etc.?  I guess that what I am really asking is how worried I should be.  Thanks so much.    

[JANEB58]

I am so sorry about your dad.  I was about your age when my dad died from a heart attack, and I know how hard it is.  I still miss my dad, but I promise you that after a while you  will suddenly realize that when you think of your dad you will be smiling rather than crying.  And, it may help you to play a stupid little game that I made up to try to be sure that I didn't forget the little things about him -- when you feel sad because you have lost him, try to think of the most outrageous thing that you ever heard him say, or the nicest compliment that he ever paid you, or the stupidest outfit he ever wore (and in may dad's case, wore AND wore), or the best time that you ever had with him, whatever . . . just try to picture the moment in your head, and I promise that it will cheer you up.    

As to our twin cysts, unless they got our ultrasounds confused, it looks like we can be surgery buddies.  I'm scheduled to have both ovaries and tubes removed either 4/22, or if OR space available, 4/18.  That's a little scary because my onc-gyn had originally said that I could wait until June for the surgery then changed his mind after he had his radiology folks at Hopkins re-read my ultrasounds.  In addition to the ovarian cyst, I also have a 1.1 cm "echogenic cervical or lower uterine segment endometrial polyp" (huh?) -- a little secret that my internist had decided to leave to the onc-gyn to share with me.  [After all this is over, she will be so fired!]  The good news is that my CA 125 was 9, I haven't had any bleeding, my pap was normal, and 2 uterine biopsies were okay.  But, I guess that with all of this taken together, the onc-gyn wants to be aggressive in my treatment.  The plan is for an outpatient laproscopic (spelling?) procedure to remove both ovaries and tubes, with immediate biopsies, and if anything bad turns up a complete hysterectomy and all that goes with it.  I was lucky enough to find a doctor I trust (with really impressive credentials), so I am pretty okay with our treatment plan.  I am keeping my fingers crossed that both growths turn out to be benign, and mostly now just want it to be over.  I do have one question, though, does anyone know whether it is common to require a bowel prep for the surgery that I am scheduled for?  From what I have read it seems that is only required if the more radical surgery is required.  So, since my doc is requiring it, I wonder if he is more concerned about cancer than he is letting on.

I hope that your CA 125 number is good -- although especially at your age, apparently good is good, but not necessarily reliable, so I am glad that you are going ahead with the surgery.  I will be thinking of you and wishing the best possible outcome for you.  Please write to let me know how it turns out.

[spunkychick]

Hello, i too have a similar situation to you. after having an transvaginal ultrasound it was found that i have a complex left ovary cyst that is 6cm and another cyst inside that one that is 2.2cm, i have had the CA125 test and are waiting results today...i am scheduled for surgery to have me left ovarie removed because of the size and complexety of the cyst, just hoping like hell its not cancer, im only 27 and just lost my dad to cancer 5weeks ago..... i too have similar symptoms to you, hurts during sex, i get accute attacks of abdominal pain like i am in labour again, lack of apetite, nausea, incontinence....hoping that the surgery will clear all this up and i can get back to good health again.... I suggest you to get a good doctor that gives you all the info and it really is a miracle nowadays what medical science can do for you, i wouldnt worry too much at this stage and try and focus on the positives of resolving your health issues and feeling 100% again.

[Nursemommy34]

The least I could do.
Good luck.
Nursemomm34

[JANEB58]

Thanks so much for your response.  It helped me get through the weekend.  I did talk to the oncall who couldn't be too helpful.  And, today, I talked with my own internist.  She said that although the cyst is complex, it doesn't have the "characteristics" common to a malignant growth -- although, of course, we were only talking in generalities.  She ordered a CA 125 test which I had today -- and I have an appointment with an oncology gynecologist at Hopkins on  Monday.  So, I am, at least, doing something.  Compared to many of the other postings on this site, my problems are minor.  I will see what the test shows, and what the doctor says, and will go from there.  Whatever it is, it already is, and worrying about it won't change anything.  Thanks again for taking the time to respond to me.  It was very kind of you.  -- Jane      

[Nursemommy34]

Hi Jane.  
What you really need to know (and I don't see it in your summery of your report) Is if the cyst was labeled as "simple", which is when it's just a sack of water, or "complex", which means that it can have some or all of the following properties: uneven or assymetrical edges, solids mixed with the liquids inside, solid center, vascular or blood filled center, greasy appearance on echo...there's some more, but basically anything outside of a clear cyst is a complex cyst.
Now, the report said that your cyst could have another one inside of it, or it could be another cyst right next to it...that's because on the echo, when something is transparent or clear fluid filled, anything with the slightest density that's inside of it, or behind it will look the same.  Thats why US is a good tool, but not good for difinitively diagnosing a cyst as benign or malignant.
Size, as I have read is really not the issue.  Rapid growth with certain cysts can be eye opening, though.
I had a complex cyst that was 4cm.  It was benign.  When they removed it, along with my ovary, they also found a simple cyst on my left ovary, which they removed.
Try not to get too worried.  Most likely (and again, I can't be certain), if the description of the cyst is true, and it is that transparent, and the other cyst is behind it and not in it, it is probably a simple cyst.
If it bothers you that much, just call the oncall and see if your doc is the one on call this weekend.  It will tick him/her off a little,but then again, if doc had given you a thorough explanation of the test results and expectations, you wouldn't be worrying right now, right?
Wish you well.
Nursemommy34