I am 37 y.o. female who was suffering cyclic chronic pains which sounds as Mittleschmertz with some mid cycle spotting which lasted until 1st day of the menstrual cycle on and off for years. I had some heavy uterine menstrual bleedings since I was teenager. I have chronic iron deficiency anemia because of it. Recently in 6/2008 I had pelvic ultrasound done which showed Calcified small fibroid 11mm in the left corpus, right ovary of normal size with follicular cyst 10mm. Left ovary of normal size with follicular cyst 3cm and 13mm follicule with septations. No adnexal masses or free fluid.
On September 2nd I had pelvic CT done to follow on the septated cyst and I have been found to have presacral mass of uncertain ethiology. Adnexa looked unremarkable and there is no mentionning of fibroma or any cysts with exception for small 3mm ?liver cyst. No free fluid.
MRI was recommended to diagnose sacral mass. MRI was done 9/9 and showed moderate amount of free fluid in posterior culde sac and weel circumscribed lesion over S1 sacral root which looks as perineuroma. MRI showed multipal bilatera follicular cysts. Otherwise findings were unremarkable with no lymphadenopathy or other tumors.
My Gyn is concerned about moderate amount of fluid and perineural cyst and offered laparotomy however I beleive it could be just fluid from the ruptured cysts.
My question: Can small multiple follicular cysts produce moderate amount of free fluid? and if not would you consider laparotomy vs follow up with intravaginal ultrasoiund just before ovulation in coup0le of weeks and see of fluid has reabsorbed? Perineural cysts are not malignant so I don;t see what can be found on laparotomy. May be culdocentesis will be in any help?