Ultrasound Report and Symptoms

[HikingPerc]

I have had a low back ache for nearly two months that spans across my back but favors one side one day and then the other side a few days later. My periods are irregular, my cycle starts every 10-20 days after the start of my previous cycle. This led me to my primary physician who ordered an ultrasound, general blood work and a pelvic x-ray. One thing to note is I went off of my birth control pill 6 months ago which may be why my periods are irregular. The x-ray and blood work came back normal. However, the ultrasound found a cyst. I immediately made an appointment with my gyno whom I saw today. She informed me that it is a complex cyst and I had blood drawn today for the CA125 (?) test for ovarian cancer. I will have a follow-up ultrasound in February. I came home to a report of the ultrasound in the mail and it says the following:

"There is a complex cystic lesion of the left ovary which exhibits homogeneous low level internal echoes and peripheral rim hyperemia. This is likely a benign hemorrhagic ovarian cyst which measures approximately 2.0 x 1.7 x 1.1 cm."

I asked my doctor if my back ache could be associated with the cyst and she said no, that it is too small to cause symptoms. I have two questions:

1.) Does anyone know what the wording of this report means in simpler terms or is knowing it is a complex cyst all that I can really gather from this?

2.) Has anyone else had a similar cyst with a back ache?

Thanks to anyone that may have some personal insight with this type of situation!

[hopeshell]

The CA-125 can be elevated with any inflammation, including normal menstruation.  Studies have shown that numbers that are over 100 are more likely to be malignant.  But, mine was 61 and I did have cancer.  I agree with Fungirl that most complex cysts don't end up going away and surgery is needed.   It is still most likely a benign mass.  I think it is important for you to discuss the possibilities with your doctor in the rare event that malignancy is found.  You want to know if you are going to be able to be staged during the surgery (a gyn/onc will need to be on call).   You will want to discuss your fertility wishes.   I know it is so hard to wait.  Even a very small chance of having cancer is enough to be very stressful!   If I were in your shoes, I would want to have follow-up in a couple of weeks and then likely proceed to have it removed just to be on the safe side.  But, of course, only your doctor can truly advise you on the best treatment.  The thing is that early staged ovarian cancer is usually cured with surgery.  If your cyst doesn't start to go away on its own, there is no reason to leave it there long term.  Even benign masses can cause complications over time.  Please keep us updated!  

Shelly

[fungirl1011]

Tricia,
If you are pre-menopausal, a CA125 is not an accurate test.  It just gives your doctor a marker to measure by.  The type of cyst you have is usually blood filled.  I was thought to have one in June, but when they went in to remove it, it was my bowels and lining of my stomach all knotted up into a 7cm ball!!!  You can definitely have back pain from cysts.  A complex cyst usually will not go away on it's own and will probably have to be removed.  Please keep us posted on how you are doing.

[HikingPerc]

Thanks so much, Shelly! I am feeling hopeful with caution. I did, however, receive my CA125 results yesterday but it is only slightly elevated at 36. It is my understanding that a number of things could have caused this mild elevation and I'm not too worried about it either, maybe I should be?

Thank you for sharing your experience and thoughts.
Tricia

[hopeshell]

In general, your report sounds very good.  But, unfortunately, the "only" way to know for sure if a cyst is benign or malignant is to remove it intact and have a biopsy.  Any complex cyst has a slight "chance" of being cancer.  But, a radiologist has seen many types of tumor and usually they won't say it appears benign unless it has very favorable signs on the scan.  I had a malignancy and my scan read that a neoplasm was one of the possiblities.  But, still they thought it would be benign.  Odds are with you that it is benign.  But, it still warrants close follow-up to make sure it is going away.

A malignant tumor won't get smaller in time.  It will usually grow and cause more symptoms.  But, sometimes, benign complex cysts also grow and have to be removed surgically.  Generally, when it reaches 5cm or greater or shows a trend toward growing..surgery is recommended.

I did have backache with my tumor.  It was 6cm.  I know doctor's don't usually acknowledge that small cysts can contribute to back pain.  But, there are many women who have had small cysts and do have pain.  I think it can contribute to it.   I have noticed that when I have had cysts, that my body feels pressure on one side.  This pressure can cause you to change your posture which can aggravate other back conditions.  

If you have a condition like endometriosis, the cyst and back pain may be related to that one condition.  Please do close follow-up to keep an eye on the size of the cyst.  If you continue to feel poorly, talk to the doctor about your options.  If you find yourself facing surgery, ask to have a consult with a gynecologic oncologist prior to surgery.  That way, he/she can be available to step in during your surgery in the rare event that ovarian cancer is found.  Studies have shown your overall prognosis is much better if a gyn/onc is involved in removing your malignant tumor.

I hope all clears soon!  Keep us posted on how you are doing!

Shelly