Giant Cyst, 16 wks preg, surgery

[CK216]

I just came from my OB/GYN after undergoing a specialist visit due to a large abdominal growth in may abdomin. I am 16 weeks pregnant and an ultrasound was used for dx.  My ob/gyn wants to remove this asap due to size-34cm x 25cm x19cm (this is only a guess on the size since the ultrasound screen was not large enough to capture the entire mass) Probable DX: Serous Cysticadenanoma or Mucinous Cysticadenanoma. This Dx is based on size only- My conern is that my OB/Gyn does not want to do an MRI nor a CA-125 blood test because he said the outcome will be the same-removal.  He plans to aspirate part of the tumor then remove it through an incision above my belly button.  He said aspiration was necessary or he would need to incise from hip bone to  hip bone to remove.  I am afraid that this tumor will contain Cancerous or precancerous cells and the specialist said she would not reccomend aspiration because these cells could be leaked into the abdomen, she recommended that it be removed all in one piece so the risk was lower to me.  They both said the risk to baby was low, so my concern is for myself.  He has scheduled me for surgery in 5 days, should I get a 2cnd opinion? What is the risk of aspiration vs larger incision and removal?

[MarieMichele]

I don't think a gynecologist/oncologist would be in favor of aspiration, wanting to contain the cyst contents and removing it intact and undisturbed instead. It would be best to have a gynecologist/oncologist perform the surgery and your OB/Gyn could assist. Perhaps a gyn/onc could do the surgery with a smaller incision than what the OB/Gyn described? Gyn/oncs have more education and surgical experience with these things. Really large cysts frequently turn out to be benign but it still is wise to remove them cleanly. I hope all goes well for you and the baby.

[hopeshell]

I am so sorry to hear this news.  The most important thing is that you have a gynecologic oncologist involved in your surgery.  This way, if it is malignant, he/she will be able to give your proper staging and debulking.  Odds are with you that this is a benign condition.  But, you owe it to yourself to have an expert available to help determien your condition.  Here are a few links that may help you:


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

http://www.wcn.org/findadoctor/

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


Dermoids are very common and are almost always benign.  My gynecologist's nurse had a dermoid when she was 8 months pregnant and it was benign.  After her surgery for the dermoid, she delivered a healthy baby girl.  It is so hard to have to deal with something like this.  But, keep the faith!  My thoughts and prayers are with you!  Please keep us updated on how you are doing!

Shelly

[Sconnie]

Hi, sorry to hear your news, I know its very worrisome especially when you are pregnant.  If the cyst was alot smaller, they could place it in a bag first (within your abdomen) and then aspire it safely so nothing leaks.  However due to the size, I doubt they have bags that big to place it into for aspiration.  Therefore maybe taking it away in tact in the saftest option via laportomy.  

I had/still have a 10cm cyst that was aspirated (without a bag) and the cyst wall left inside my ovary, he didnt take it because he thought it was a benign functional cyst.  Now its still there, and showing 7cm solid on ultrasound, they think its a dermoid and I am worried sick that he aspirated it and cell may have leaked.  The fluid was benign, but that doesn mean the tissue left behind isnt, and I am praying to go that it will be, as I am having the whole thing out completely by laportomy in 2 weeks.  The worry I have had, because he aspired it has made me ill.  But your case is very different, and I guess you have to do what is safest for your baby. Wish you lots of luck, Yvonne xx