Complex Ovarian Cyst with pain and weight loss

[azlabrat]

I hope some one can help me put some things in perspective. I am a 34 year old female who other than Hashimoto's and a genetic neurologic condition (Dopa Responsive Dystonia with Parkinsonism) was in pretty good shape until about 6-7 months ago. Around that time period I had a kidney infection with pain in the lower left quadrant. The infection has been treated and gone away but the pain is still there. It is always in the same spot (about 3 finger lengths below the bottom of my belly button on the left side).

I have lost 30lbs  and dropped from a size 10/12 to a size 4 without any diet or exercise. I get daily nausea, dizziness, hot flashes(?), and pain.  On several occasions the pain has been bad enough for me to go to urgent care or the emergency room as even doubling the dose on the prescription pain killers the doctor prescribed could not touch the pain. Three months ago was the first time it was so bad that all I could not walk upright and when I got the emergency room they said that I had acute pancreatitis and admitted me. I was in the hospital for 4-5 days and while again my pancreatic enzymes came back down to normal the pain is still there. None of the doctors at the hospital were able to figure out what caused the pancreatitis.

During all of this my work insurance changed and I found myself having to deal with all new doctors because my normal doctors did not accept my new insurance. Luckily I was able to get on my husbands insurance this past month and was able to see my old GI doctor who has been running the tests that she felt should have been run first.

One of these tests was a pelvic ultrasound which has shown a complex mass on or near the left ovary. The mass is not very large only about 4 cm but it has some unusual attributes to it and does not seem to nicely fit any of the complex cyst classifications for ultrasound. The options that the radiologist listed were hemorrhagic cyst, infected cyst, endometrioma, or a neoplasm. The radiologist suggested a MRI of the pelvis which I am having done tomorrow and my GI doctor said I needed to talk to my gynecologist as soon as possible. However when I talked to my gynecologist and took him the report he seemed unconcerned. He has not ordered an lab tests and while he is going to take a look at the MRI he did not feel that the scan was necessary, otherwise if my GI doctor had not ordered it he would not have. However he says he can take the cyst out and check for possible endometriosis via a laproscopic surgery.
So here are my questions;

1. Can a small complex cyst cause the symptoms I have been experiencing?
2. Would you talk to another gynecologist and get their opinion as I am not sure my doctor considers this a cause of my pain even though he is willing to take it out? I am just worried that if does take this seriously some steps will be skipped that should not be. Like should he have ordered a CA-125 test?

Any advice you give would be appreciated I do not like the idea of surgery but I am miserable enough to do it if it is the only choice I have. I just want to feel more comfortable with my decision than I do now.

[Lisajayne70]

Hi napua, just read your post 30cm is big, what type of cyst was it & what were your symptoms?

Lisa x

[GYNsymptoms]

Yes, you defnitely need to be your own advocate!  I was told not have a pelvic ultrasound unless I got a fever.  The pain never let up so I went to have one anyway and now surgery may be in my future.  Good luck, I hope you can conceive without too much effort!

[azlabrat]

Just a note have not gotten the MRI pelvis results yet but the MRCP that they did about an hour or so before the pelvis showed narrowing of the small intestine. Starting to worry this may be more serious than a ovarian cyst.

[Napua]

My 30+CM cyst almost went undetected.  Surgery went fine though.  But I still get pain and such....my body is still adjusting.

All tests and such came back great.  no cancer.

[azlabrat]

Thanks for your response. Actually it did help. I think once I have the results from the MRI I am going to get a second opinion just to put my mind at ease. I don't think the mass is cancer but I am willing to do the surgery IF there is a good chance that it could relieve my symptoms as I am sick and tired of being sick and tired.
I think the thing that was bothering me was that my GI doc sent the ultrasound  report over to him and all he did was file it. If I had not mentioned it he would not have done any other follow up which seems rather odd. Even if  he did not think it was cancerous I would think my other symptoms or the fact that me and my husband have been trying to conceive for going on 3 years now would have made him want to follow up.
So the second opinion will be good for two reasons as the other doctor I am going to see also does fertility evaluations. Figured before I let someone go cutting on me I wanted to have an idea what my chances of getting pregnant are.

[GYNsymptoms]

Hi there - I had a 5.1cm cyst causing pretty bad daily pain on my left ovary with something unusual about it also found by a vaginal ultrasound.  They rechecked it in 4 weeks and it was down to 2cm but still has something solid attached to it that is unidentifiable.  My GYN DID draw a CA-125 after my first ultrasound and it came back negative. We are going to recheck it in 2 months now and see what it looks like. My doctor has offered me surgery at each visit and says if it is still there in Nov she will encourage I get it out so they can see what it is.  I have not had any weight loss with it (unfortunately!! :o) )  Does this help?