Complex Ovarian Cyst

[Confused1965]

Hi all - I was diagnosed on June 22, 2011 via transvaginal ultrasound with a complex ovarian cyst on my left ovary measuring 5x3x2.4.  I saw my ob/gyn today.  He said he could not "feel" so it must not be there.  Could this cyst have resolved on its own?

[Confused1965]

Thanks for the advice.  I have requested my PCP send me for a MRI and I am making an appt for a second opinion with an ob/onc tomorrow, their office was closing for the day when I called this afternoon.  I just cannot let this go, I have to follow-up for my peace of mind.

[kcd86]

You have to get out of your mind about hurting any Dr's ego's when it comes to your health. You don't ever want to hear from a Dr's mouth well I thought it was this or we should have done this. You need an MRI if it confirms there is nothing there all is good, if not then if you listened to him you might have regreted it.

[Confused1965]

By the way - the cyst is not small - it is 5x3x24 cm.

[Confused1965]

I am so sorry to hear about your wife and appreciate the time you took to write me back.  

I have been seeing my ob for over 30 years and I hate to second guess him but the u/s definitely says complex ovarian cyst and the dr. says because he can't "feel" it on manual examination it must not be there.  I can not rap my head around this being right.  He also said my uterus is enlarged but the u/s says it is normal.  I am confused and don't know which way to turn, do I trust his judgment and take a chance or do I get a second opinion.  I will take your advice and request that my PCP send me for a MRI, I doubt my ob will do so.

Thanks for your advice and again I am sorry to hear about your wife. I will keep you in my thoughts and prayers.

Sue

[kcd86]

You should at the very least have a repeat tv ultrasound. On tv ultrasound they can tell if it's a simple cyst vs complex/solid, the later will not go away on its own.

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), complex, solid 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. **********
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Since there is some suspicion  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. ######
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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.
Kevin