Bilateral Ovarian Dermoid Cysts

[shyla_jane]

hi!...i am 25 yrs. old and have found out that i have ovarian cysts. My ultrasound result is this: There are two, closely apposed complex cystic pelvoabdominal masses, more to the right, each cyst measures 10 x 7.7 cms.
and 9x6.9 cms. A complex cystic mass is also noted at the left adnexa
measuring about 7 x 4.3 cms. Impression: Complex cystic masses as described probably due to bilateral ovarian dermoid. the cysts on the right may represent a single mass with loculation and lobulated contour.

can this be remove through laparoscopy? my dr. said i will have an exploratory lap/open surgery.. I still have doubts regarding this operation and i am scheduled for next week.

By the way any preparation i should do before the surgery?

Your advise and opinions are highly appreciated... thanks

[hopeshell]

Thanks you.  No, there is no need to reschedule your surgery due to your period.  I actually had just started mine when I had my ovca surgery.  Keep us posted on how you are doing!

[shyla_jane]

i have news, i just have my menstruation today.. so i think i'll postpone my surgery.. i think i'll reschedule it after my cycle is over.. thanks for the advise..you're very good.

[hopeshell]

It is very normal to be scared.  I think the worst time for me was waiting for the surgery.  Try not to worry.  Most surgeries go very well and it is over before you know it.  My incision is very long.   It is vertical and begins at my pubic bone and goes past my belly button by two inches.  Yours will not be this long unless cancer is found.  Usually, they begin at the pubic bone and go just under the belly button.  When my doctor found cancer, he circled around the belly button and then went straight up so he could remove my omentum and sample more lymph nodes.  When I woke up, I had many stapes keeping the incision closed.  It wasn't pretty.  It was very red and keloid like for a couple of years.  Now, three years later, it is white and blends better than before.  But, I was not happy about having to have a scar like this.  I tried every cream on the market to make it better.  But, I now look at it and realize, without it, I wouldn't be here.  So, this is just one of those things you can't change.  Your incision will likely be much less than mine.  Most doctors still prefer a vertical incision verus a horizontal one, but you could ask your doctor about it.  Hang in there and try not to worry.  I have a good feeling you are going to be ok.  :)

[shyla_jane]

im kinda scared as the date is coming near, can i ask you about your incision.. how big is it and how is it now..yeah i really hope it well all go well...

[hopeshell]

You will have to go without food and water for a period of time before your surgery.  Most doctors here in the US have you drink a laxative to clear out your bowel.  It is usually the same drink they patients before a colonoscopy.  It is not a pleasant drink.   My doctor told me this step was needed in case cancer was found on my bowel.  You may not have to have this drink if your doctor is not concerned about malignancy.  Other than that, nothing much is required.  I hope all goes well!  

[shyla_jane]

thanks a lot! anyway what preparation do you think i should do before the surgery..

[hopeshell]

It is very rare, but dermoids can be malignant.    Good luck on your your surgery.    Keep us posted on how you are doing!

[shyla_jane]

hey you're right kinda difficult to find gyn/onc.. well i've discussed the fertility issue with my gyn but i haven't thought asking about the possibility of cancer because they said its dermoid and told me that its benign..so i don't know..but i like your suggestion of consulting a gyn/onc hope i find one. Thanks a lot!

[hopeshell]

I just read that you are in the Philippines.  In some countries and even in some cities in the U.S., it is very difficult if not impossible to see a gynecologic oncologist.  I do not know how feasible it is for you to find one in your country.   A gyn does commonly perform this type of surgery and so please don't worry if this is your only option.  It is very likely that your cysts are not cancer and having a gyn/onc is just the "safest" bet if you can see one.  Many women have these surgeries performed by their gyns and all turns out well.

But, I would think you need to ask your gyn the following questions:

1.  Will you perform a frozen section during surgery to determine if it is cancer?

2.  If it is cancer, will you be able to stage my cancer?  If not, then how will I be staged?

3.  What if you find other tumors in my pelvis?  Will they be removed?

Have you also talked with your gyn about fertility and the possibility of losing your ovaries during the surgery?  That is an important thing to discuss prior to surgery.

It is important that you know what to expect after your surgery.   You need to have the surgery because of the size of your cysts.  If you still feel uneasy after talking to your doctor, you may want to get a second opinion.  

Hang in there!   Best of luck to you!

Shelly

[shyla_jane]

thanks a lot, my doctor didn't tell me to have that kind of tests.. shes an ob/gyn and she said she"ll perform the surgery(cystectomy). do you think thats ok?

[hopeshell]

I am sorry to hear of your cysts.  Unfortunately, due to their sizes, the laparotomy is the only safe choice.  It sounds like your doctor is on track.  Have you had a MRI or CA-125?  Most complex masses do turn out to be benign. But, there is a possibility of malignancy with any complex mass.  

It is recommended that you get a consult with a gynecologic oncologist for any ovarian mass that has a "possibility" of being malignant.   A gyn/onc has seen many types of tumors and many cases of malignancies.  He can give you his opinion about your tumor, order tests and most importantly, be available to step in and complete your surgery if malignancy is found on your frozen section.   A gyn/onc can also stage you in the same surgery and remove any other tumors that are found.  Studies have shown this improves your overall prognosis.  Here are some links that explain more about a gyn/onc:

http://www.wcn.org/articles/treatment/gynecologic_oncologists/overview/

http://oreilly.com/medical/news/ovarian_ten_things.html


Most of the times complex cysts turn out to be benign.  But, there is no way to know for sure before surgery.  I think it would be important to discuss the gyn/onc issue with your doctor if you aren't already seeing one.  

Good luck with your surgery and keep us posted on how you are doing!