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Ovarian cyst. Help understanding ultrasound

I am 36 years old. I went into my GP with complaints of lower abdominal pain radiating to my back (or vice Versa, at the time I didn't know which way it was going), feeling bloated, periods just recently being shorter than normal (and then normal and then shorter again), and also feeling like I had a UTI (which was clean, I did not). I also felt like I was occasionally constipated. She put my on a high fiber diet, and also sent me for an ultrasound. I don't understand how to interpret the results and my appointment isn't for another week away. I am really nervous what this all means.

Complex appearance right adnexa/right ovary noted with right ovary measuring 8.5 cm x 5.3 cm x 6.3 cm. Hypoechoic mass right ovary with low level internal echoes reflecting either solid mass or complex cyst. Mass measures 9.5 cm x 5.6 cm x 5.9 cm. Mural nodule right ovary measuring 2.4 cm x 2.0 cm x 2.5 cm and a second nodule demonstrated measuring 2.6 cm x 2.4 cm x 2.2 cm. Nodules appear avasuclar on color vascular flow assessment.

Enlarged left ovary measuring 4.7 cm x 4.2 cm x 3.1 cm. Cyst left ovary measuring 3.1 cm x 2.9 cm x 2.5 cm adjacent smaller follicle measuring 5mm. Contiguous with cystic structures, hypiechoic solid mass appearing mass measuring 3.1 cm x 2.9 cm x 3.8 cm.

Doppler and color vascular flow assessment demonstrates evidence of vascular flow bilateral ovaries.

No free fluid found in pelvis

1. Complex appearance ovaries which are enlarged, right greater than left.
2. Suspected complex cyst with internal echoes and mural nodules right ovary
3. Complex cyst versus solid mass left ovary. Adjacent left ovarian cyst.
4. Follow-up assessment of each above described finding advised
5. Cervical cysts
6. Mildly thickened endometrium won subtle heterogeneity

My anxiety is getting the best of me. I know cysts are common, and that even complex cysts can be begnin, but I'm still worried about cancer. Specifically when it comes to the larger mass/cyst as well as the solid cyst. Does anybody have any insight for me or could at least give me a better understanding of what this means?

When my GP called me with the results all she basically said was because of the discomfort I'm in and the results she is referring me to an ob/gyn. That made me feel like it wasn't something I should be worried about. And then I got the results in the mail.

Any help or advice would be greatly appreciated. Thanks!!

3 Responses
Avatar universal
Imaging is not exact so it can be difficult to tell the type of cyst. Even solid appearing cysts can be benign and ones that resolve on their own (hemorrhagic specifically). Multiple adjacent cysts can appear as one complex cyst as the borders can look like septations.

And, yes, most cysts including complex ones are benign.

Being that you have what appear to be multiple cysts, do you possibly have Polycystic Ovary Syndrome (PCOS)?

If these cysts do not resolve on their own and you end up needing surgery, be aware that many women lose an ovary or ovaries for benign cysts. That is SELDOM necessary IF you have a surgeon who has good cystectomy (cyst removal) skills and is willing to take the extra time and care (with possibly no more reimbursement $) to do a cystectomy. This is a pretty good website about ovarian cysts - http://ovaryresearch.com/ovarian_cysts.htm.

Unfortunately, I've read of cases where surgeons with good cystectomy skills were outside the patient's insurance network and they had to appeal to have this surgery covered as in-network. I don't know if this is common or not. Removal of any part of the reproductive system (even one ovary) can permanently disrupt natural hormone production which can have serious negative effects on many aspects of health. The other ovary can sometimes compensate but there's no guarantee.  

The uterus, ovaries and tubes have lifelong non-reproductive functions with the ovaries producing hormones a woman's whole life. Hysterectomy and oophorectomy (ovary removal) when done for benign conditions are associated with long-term negative effects.

Best of luck in getting answers and figuring out how to proceed. Please keep us posted.
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Thank you very much for your reply. I've learned so much over the last week, with all of the research I've done. I will be glad when Monday comes and goes.
Avatar universal
My ultrasound results and symptoms were similar to that of your's. I couldn't get any awnswers/solutions until I saw my OB. My Dr. and ER acted like it was nothing to worry about. However my OB ordered blood cancer screenings (all negative) and scheduled emergency surgery to remove the cyst. It had grown rather large and was semi-solid. She had to remove my left ovary and Fallopian tube. The cyst had nearly consumed my entire ovary and was causing tortion and that was adding to the severe pain. I know every case is different. Its just best  to prepare yourself if you go for a cyst removal they may unfortunately have to remove the ovary. I am terribly upset because I am 37 with one child and was really hoping to have another child  but I may need to take birth control now to prevent cysts on the other ovary. I will also find out in 2 weeks if it is benign or malignant. Best of luck!
Thank you so much for your response. May I ask what kind of surgery did you have? Larascopic or open? There's so much pressure in my abdomen now  that I just want it out, but I want to be prepared for whatever surgery may come. I almost feel like it's gotten bigger since I've gone for the ultrasound almost a month ago. It feels like I'm pregnant on one side of my body! Thanks again
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