Ovarian Cysts Community
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21 year old with 9cm complex ovarian cyst

Hi guys,

So recently my gyno found a cyst during a pelvic exam, and I had an ultrasound done the day after. The results showed a 9cm complex ovarian cyst with thin septations and low level echoes. They said based on its appearance, it could be a dermoid cyst, but it is non-specific. I finally met with a gynecologic oncologist who could potentially do the surgery, and he told me that because it is complex, he would like me to get an MRI first to determine if it really is a dermoid or another cyst that may have a chance of shrinking. He wants surgery to be my last option since he would probably have to remove my ovary and tube.

My question is, should I be concerned that this is cancerous? I didn't think too much of the septations and echoes, but once I googled it, most articles said it wasn't always the best thing. I don't have a family history of ovarian cancer, but my mom had breast cancer and my paternal grandmother did and aunt did. My mom was post menopausal and so was my paternal aunt.  Honestly I'm freaking out, and the MRI is in a week so I'm nervous and anxious to get it over with. Has anyone had an experience like this (septations and echos) and still had their cyst be benign, just complex?
1 Responses
Avatar universal
My cyst was similar to yours - about 9cm and complex with thin septations and, I believe, low level echoes. If it's any consolation, most ovarian cysts, even complex ones, are benign. (Dermoid cysts are always benign.) Yes, there are certain traits that make some more  suspicious than others but, again, the large majority of cysts are benign. Thick septations are more concerning than thin. And sometimes multiple cysts can look like one cyst with septations since imaging is not exact. Ovarian cancer is rare with the average woman's lifetime risk being less than 2% (1.3% per U.S. govt stats).

It's good that the gynecologic oncologist isn't in a rush to do surgery. But it's concerning that he said he'll have to remove your ovary and tube. There are surgeons that have good cystectomy skills that can remove just the cyst and save the ovary or enough of it for normal fertility as well as long-term health. But you may have to seek out one with these skills.

The ovaries produce hormones a woman's whole life. They merely change from their reproductive role to their endocrine role after menopause. Removal of even one ovary can permanently impair ovarian hormone production and the endocrine system. Plus it can impair fertility. This website may be helpful - http://ovaryresearch.com/ovarian_cysts.htm.

Please keep us posted on what more you find out.
Thanks so much for your response! It definitely helped ease my mind a little.

I was surprised yet not that the surgeon mentioned possibly removing my ovary and tube. Not surprised because I know it's rather large, but also surprised because as you said, I know some surgeons who were able to remove large cysts while keep the ovary in tact. I'm going to bring this up with him if surgery becomes part of the plan.

I'll update this post once I get more info! Thanks again for your response :)
You're welcome. Since the cyst is rather large, you don't want to wait too long to see if it resolves since you run the risk of ovarian torsion. In the meantime, you may want to pursue finding another surgeon who does a lot of cystectomies so you can be ready for surgery. Depending on your insurance situation, there may not be many (or any) of these surgeons in your insurance network. I recall a woman in California having to file an appeal to her insurance to cover cystectomy at an in-network rate because she could not find a surgeon in her network that did cystectomies.
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