Biopsy for complex cyst?

[scajmaika]

My OBGYN is recommending that I have laparoscopic surgery for complex, thick walled ovarian cysts (2 cysts being approximately 3 cm each) in 2 weeks.  I would appreciate anyone's input. Here's my story:

*Rt. ovary/fallopian tube removed 13 months ago; diagnosed with hemorrhagic cyst; endometriosis; serosal adhesions.

Current infomation  was gathered from 2 ultrasounds, a CT scan and a MRI. Information includes:
* Aug. 23 Ultrasound revealed 2 cysts measuring 2.9 and 2.8 cm with one cyst having low level internal echoes; Impression: hemorrhagic cyst
* Aug. 27 CT scan revealed 2 slightly thick-walled cysts measuring 5.0 and 3.8 cm with dependent hemorrhagic content; mild to moderate hydrosalpinx; endometriosis along sigmoid colon; no significant volume of pelvic free fluid; Impression: endometriosis with left ovarian endometriomas
* 9/9 MRI pelvis revealed free fluid in pelvis and complex, moderately thickened walls cysts; “dialated tubular structure measuring 4.6 cm” possible hydrosalpinx; Impression: hemorrhagic cyst

CA 125 : 70
diagnosed as "slightly anemic"

I'm down to 'one set of parts' since my right ovary/fallopian tube was removed 13 months ago. So, would anyone be able to offer what information here makes my OBGYN want to do a biopsy. I do have pain and a "full feeling" in my pelvis. Thanks for anything you can offer. Just trying to think it all through.

[scajmaika]

Thank you very much for your responses. I got a second opinion with an OBGYN, and I feel confident with her recommendations (do not have surgery now, take pill to see if that helps with cysts, and follow up after each cycle with an ultrasound). SHE brought up me seeing the GYN oncologist if my situation warrants that.

I really appreciate you taking the time to answer my post. I will most definitely see a GYN oncologist if surgery is necessary.

[hopeshell]

I agree with both comments above.  It is very important to get a gyn/onc consult.

[kcd86]

Like Dian07 said 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 (only if it turns out to be ovca) by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management.  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.

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

[dian07]

My advice to you would be to get a referral to a gyn/oncologist ; not because this is cancer, but just in case.  Besides your ob/gyn isn't trained specially for this situation....a gyn/oncologist is.  The expertise held by a gyn/oncologist can directly affect your future.
If your doc doesn't want to make a referral for you then simply call and make an appt for yourself.
When I was told by an obg I needed surgery, I immediately asked , "If I was your wife of daughter, where would you send me ?", and, that's where I went.  It was a three hour drive but that was five years ago.....I"m glad I went.
YOU HAVE ONE CHANCE TO GET IT RIGHT THE FIRST TIME.......see a gyn/oncologist.
Please do keep us posted.
Peace.
dian