9 cm right ovarian complex cystic mass

[Jcrow1001]

I am 37 years old and having laparoscopic surgery on 3/26 to have it removed.  The sono came back inconclusive and the MRI said it was worrisome for a possible cystadenoma or cystadenocarcinoma.  Tumor markers and surgical correlation was recommended.  My CA125 came back at 10.  There are two septated areas in the mass both measuring about 3 cm.  One is in the upper right quadrant and one is in the lower left quadrant.  There is no free pelvic fluid.  I can't feel it or see it except for when I ovulate I feel pressure in my rectal area.  My doctor tells me this is because it's getting inflamed caused by ovulation.  I think it has been there for a long time as I have had this symptom for awhile every time I ovulate.  I'm not on any birth control and I've never had a problem with cysts before that I am aware of.  I always thought I was just having normal ovulation pains.  The cyst was found incidentally on a sono that I had back in January for something else.  I always thought that the pains I was feeling mid cycle were just normal ovulation pains.  My doctor believes this cyst is likely benign and I could even wait a few months to see if it disappears but I want it out so I opted for the surgery.  I'm really worried about this and are there any questions I should be asking my doctor before I go into surgery?

[Annekathryn Goodman, M.D.]

Dear Jcrow,

It sounds like you have gotten very good care.  I agree with your doctor's recommendation. Most cysts are benign. You know your body and you are probably right about this cyst being present for awhile. But ultimately, until you have a biopsy, you cannot know if it is benign or malignant.  I agree with Peaches comments as well.

As far as questions for your doctor, you should ask:
-what is the chance of converting to a laparotomy? How is the recovery time different?
(2 weeks versus 6 weeks)
-what are the plans if a malignant cyst is found? Do you want to have a more extensive surgery with the removal of the uterus both ovaries and tubes and staging biopsies on the same day or to have a bigger surgery rescheduled to a different day?
-does your doctor feel a gyn oncologist should be available for back up?


best wishes to both of you for your upcoming surgery

[Peaches68]

Hello, I am 39 and having my surgery 3/28 for a 10cm cyst.  It was found during my routine exam.  I was told it has 1 septation with no abdominal fluid.  My CA 125 was 4.  I have opted to have both my ovaries removed (they are all i have left there anyway)  I dont understand all the dr. terms but as mine are telling me, they just wont know till they do a good ole biopsy.  I hope all goes well for you.

[Jcrow1001]

I think that both of ours are likely benign with such low Ca125 levels.  Unless we are in that 50%.  I am trying so hard not to worry about it....easier said than done as I'm sure you know all too well!

I hope all goes well for you too!

Janet

[Jcrow1001]

Is there a specific reason you are opting to have your ovaries removed...if you don't mind me asking of course.  I would like to keep mine if possible to acoid the whole surgical menopause thing.  I am having my tubes tied though.

[Jcrow1001]

Thank you so much for your response.  My Dr. had originally mentioned having a gyn/oncologist present but since my Ca125 came back normal, he is not sure if it is necessary.  Is that something I should insist on?  He has told me that there is a possibility of having to convert to a laparotomy.  I have had prior exploratory surgery for ITP when I was 16 and there may be scar tissue that would interfere with the laprascope.  I have read that mucinous tumors don't produce Ca125.  I seem to be comforted by numbers but it's not very comforting when 50% of Stage I cancer doesn't produce an elevated CA125.  

[Annekathryn Goodman, M.D.]

Hi there
it sounds like you are in good hands with a doctor who is carefully thinking about the options.
please let us know how your surgery goes
take care

[Peaches68]

I just want it all gone, i have had cervical cancer, eptopic pregnancy, scar tissue and cyst.  I am just soooo tired of it all.