Complex Adnexal R Cyst with Thick Walls

[genevieve71]

Hi everyone, Thank you so much for this beautiful forum, from which I have gotten so much wonderful advice all morning in reading everyone's accounts with ovarian cysts. I am a 42 year old, otherwise healthy woman with no familial history cancer, but a maternal history of postmenopausal ovarian cysts and uterine fibroids, all leading my mom to have her cysts and ovaries removed in her 50s. For the past 6-12 months, my menstrual cycle has been regular at 28 days, but periods have been a very heavy blood flow with unprecedented, debilitating cramps, causing me to miss work on day one of some cycles. I had no interest in going on birth control pills as I was on them from age 20 through 35 and don't want to ingest any more hormones. So it was ibuprofen that was my best friend and my heating pad. 10 days ago, I began to have severe lower abdominal pain bilaterally with no menstruation, writing it off for a week as an intestinal virus and popping 4-6 ibu's a day to control the cramping. Finally on day 8, this past Monday, I have sharp, take your breath away cramps in my right lower quadrant so I went to the doctor to get a pelvic exam, worried I had appendicitis. He ruled it out and ordered an ultrasound for the next morning. The ultrasound yesterday morning revealed a normal uterus and lining, and normal left ovary, but a 6cm complex cyst on my right ovary with thick walls, worrisome for neoplasia, according to the radiologist. Tomorrow I drive 1.5 hours to the nearest big city, St. George, Utah (funny, as for 40 years, I lived in NYC and worked across the street from Sloan Kettering and all my GYNs were from Weil Cornell, so ti would have been 20 minutes, not a 1.5 hour drive, but i live in a small town right now), to see a board-certified GYN for a pelvic exam and this time a transvaginal u/s. I will ask for an MRI too. I would like for them to surgically remove my right ovary with its cyst/mass as I am not having children anyway. I would like to take an aggressive approach, not a wait and see if it grows. Any advice on how to convince them to just take the ovary from me? Possibly my left one too while they are at it? Should I ask for the CA125 test tomorrow? Must I fast for it though? Should I ask for the other blood marker tests or is that overkill? Thanks for all your help and for listening and being there all for each other. All my best to all of you, Genevieve

[salvic]

Hope all goes well x

[genevieve71]

Thank you so much, Dr. Kaur, for your thoughtful answer. I went to a board certified GYN this past Thursday and he performed a transvaginal ultrasound to confirm what the first radiologist saw. Indeed the cyst in complex with many solid areas. He doesn't like the look of it and has scheduled my laparoscopic surgery for this coming Wednesday. My partner will come with me of course and my Mom will fly out from NYC to help him care for me post-op. My GYN said it could certainly be a hemorrhagic cyst and the solid parts could be clots, but he won't know unless he opens me up, removes the mass in tact and sends it to pathology at the hospital. Cross fingers. No CA125 test was done. He's just going in to take the mass out so we will know soon enough. How long does pathology typically take? Thank you! Best Genevieve

[Bhupinder Kaur, MD]

Hello,
A complex ovarian cyst is less common than simple ovarian cyst. Complex ovarian cysts are generally benign. The risk of malignancy is generally higher among postmenopausal women. Before going in for any oopherctomy get a CT scan abdomen and a CA125 done to rule out any neoplasia.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.