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How concerned should I be of the scan results on my ovarian cyst?

Do you have any suggestions/opinions for me re: the following results from my scans?    *I'm waiting for my appt with the gynecologist. My first response is to have a full hysterectomy, however, I'm reconsidering after reading other responses in this community re: horomones and the overall functions of the ovaries and uterine beyond pregnancies.  **I'm 41 and have thought that I've been pre-menopausal since 37.  

Scan results:  3 cm complex cyst in right ovary, low-level internal echoes and internal septa.  differential would include endometrioma, hemorrhagic cyst vs cystic ovarian neoplasm.  layman terms: abnormal appearance to the endometrial. neoplasm not excluded.  3cm complex cystic mass.  free pelvic fluid.  heterogeneous myometrium consistent with history of uterine fibroids but no discrete fibroid at this time. --endometrial complex is abnormally thickened at 18mm.  
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Avatar universal
COMMUNITY LEADER
Hi.  I'm sorry you are dealing with this. You are right to be rethinking a "full hysterectomy" since the uterus and ovaries have lifelong functions. (Ovary removal is actually a separate surgery called oophorectomy or ovariectomy. Hysterectomy is removal of the uterus only.)

You shouldn't need any organs removed and, at this point, there's no indication of surgery being needed.

A 3cm cyst is small and most cysts resolve on their own. And even when they don't, the large majority are benign. Periodic ultrasounds should be the standard recommendation at this point. If the cyst continues to grow, ~7cm seems to be the point at which they want to do surgery due to the risk of ovarian torsion. If the cyst continues to grow, it is best to have just the cyst removed (cystectomy). Removal of even one ovary has been shown to be harmful. So you would want to find a surgeon who has good ovarian cystectomy skills.

As far as the 18mm endometrium: At what point in your cycle was the ultrasound done? This isn't much thicker than normal when it is close to your period starting. Also, if you are perimenopausal (hormonal changes and cycle irregularities leading up to menopause), the lining typically gets a little thicker than normal. Additionally, if you have small fibroids or polyps those can be difficult to differentiate from the lining itself making it appear thicker than it is.

What did your doctor say about all this?   If he recommended surgery, that obviously seems overkill. An endometrial biopsy may be warranted but rechecking a day or two after your next period would seem to be an option.    
2 Comments
Thank you. I'm thankful that I've had a few weeks before my specialist appointment (tomorrow) to be able to research and better understand my situation.  My scans were done est. 5 days before my cycle started so I'm wondering if that was the case.   I forgot to comment that my paternal grandmother died of Ovarian Cancer 25 years ago, hence, my GPs concern. Thank you for the encouragement to take the process much slower than I was conjuring up in my mind. Have a lovely day.
I had started to mention that an increased risk of ovarian cancer may warrant surgery but, for some, mentioning "cancer" can make for a heightened sense of fear that can lead to poor judgment / decisions. That was my experience.

Of course, ovarian cancer is rare for the average woman. And I've read that only 5-25% of ovarian cancers are due to genetic mutations. Have you considered genetic testing? If you have a number of other female paternal relatives that did not have OC then it would seem that you would be unlikely to have it or get it. Also, based on my understanding, if your paternal grandmother was post-menopausal when she was diagnosed, there is a higher likelihood that hers was not genetically driven.  
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