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Old 09-28-2009, 08:41 AM   #1
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Red face Complex cyst 4.8 cm

Hello-

I'm 41 with a long history of ovarian cysts. In 2002 had a 9cm dermoid removed with most of my left ovary. Have had several functional cyst since. They have been watched and eventually went away.

I have recently had two episodes of severe abdominal pain and after the pelvic ultrasound was told a cyst had burst (I had fluid in my abdomen)- re-check in 6 weeks. My doctor seemed unsure if this one would resolve on its own.
I obtained my report and it shows a 4.8cm complex cyst with internal echos and irregular internal septations. Impression consideration~ hemorrhagic, endometrioma or cystic neoplasm. Also, calicification adjacent to the edometrial stripe. No left ovary could be seen.
Im worried this time more than any other and am wondering if anyone has been through something similar.

 
Old 09-28-2009, 07:57 PM   #2
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Re: Complex cyst 4.8 cm

I really don't know a lot about cysts, but I am certain someone will come along to help soon. I wish I could help more.

 
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Old 09-29-2009, 01:25 PM   #3
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Re: Complex cyst 4.8 cm

Thank you Pickle Eyes. I really appreciate you taking the time to reply. Maybe I'm worrying before I need to. It's just with having had these cysts come and go for years and now being told this one is different, it made me wonder how common this was. I think the word neoplasm was the most worrisom. My OB/GYN did talk through all the scenarios and also mentioned they couldn't rule out cancer so I got scared. Hopefully at the 6 week ck, it will be gone...although 6 weeks is a long time to wait.

Thanks again, Lisa

 
Old 10-02-2009, 04:53 AM   #4
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Re: Complex cyst 4.8 cm

Hello Leafy,

Has anyone recommended the CA-125 test to you ? This test does have a high rate of false positives and false negatives so it is not used for routine screening of ovarian cancer. It may, however, offer you some reassurance because ovarian cancer will normally show up with a very high reading in patients. Discuss this with your doctor and see what they say.

The word neoplasm simply means new growth and neoplasms could be benign. For example, when I had a 9 cm simple cyst on my left ovary, this could have been referred to as a neoplasm as it was not a normal functional cyst. If you have had dermoids before, this could also be another one.

If you are uncomfortable with waiting, get a second opinion or even an internal ultrasound so that they can have a closer look at the cyst. With an internal ultrasound they can also do a doppler flow analysis to see if there is any bloodflow to the cyst. This may give you more information.

Although it is true that they cannot rule out ovarian cancer, keep in mind that this is still a rather rare disease (not impossible, but rare). On the other hand, ovarian cysts, even complex ones, are extremely common. This means that the chances are greatly in your favour that the growth is benign. Try to concentrate on this rather than on worse case scenarios (believe me I have been through this and it is HIGHLY counterproductive .. you will loose sleep and brain cells and you will accomplish NOTHING by doing this).

I wish you all the best and hope that the cyst resolves on its own. The fact that it is less than 5 cms is very reassuring (cysts that are larger rarely resolve on their own and must be removed). Take care of yourself and let us know how you are doing.

Estria

 
Old 10-02-2009, 07:31 AM   #5
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Re: Complex cyst 4.8 cm

Estria,

I've read about the CA-125 test but it has not been offered. I'm really trying to not think about it and just wait for the 6 week recheck. Today is the 2 week point so I have 4 to go. If it's still there, I will request this test. I wondered if it made sense to have it since there is the likelihood of false negatives but how you have explained it makes sense.

My dermoid was the size and shape of an eggplant. I remember my doctor commenting that she had never seen one look the way mine did. I did not realize this type could be considered a neoplasm. Thanks for explaining it!

My ultrasound was both on my abdomen and internal. My gyn has always done a complete pelvic ultrasound every time they have to follow another cyst. She does seem to be very thourough. 2 weeks ago it did show that it had blood flow to the growth- I think anyways...the report showed internal echos and irregular internal septations. Am I understanding this correctly? What exactly does this mean when there is blood flow?

I have had this sudden severe pain (lasts about an hour) now 2 months in a row- 19 days into my cycle. I'm just hoping that 10/4 (which will be the next 19 days) it doesn't happen again. I'm guessing it's related to ovulating that causes the cyst to burst or leak that causes this horrible pain. The doctor put me on bc pills a few years back thinking it would stop most of the cysts. She's had to switch my pills because my BP was out of control.

Thank you for your kind words and suggestions. Especially about not concentrating on the rare possibility that it could be cancer. I know I shouldn't think about it but it helps to have someone say it to me.

Lisa

 
Old 10-03-2009, 09:04 AM   #6
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Re: Complex cyst 4.8 cm

Hello Lisa,

Glad to hear that your doc already did an internal. This is good. Blood flow to a cyst does not necessarily mean that it is cancerous. The idea behind the doppler flow analysis is to see how resistant to blood flow a new growth is. It is believed that new tumours have less resistance to blood flow because they are less developed. However, and this is a huge HOWEVER, in premenopausal women this test is not very reliable because there is a huge overlap between blood flow resistance in functional ovarian growths and stage 1 cancers. In post menopausal women, you will not see many functional ovarian growths as they should not be ovulating. In premenopausal women, however, functional cysts are normal. The doppler flow analysis therefore gives a little more information but, like the CA-125, it is not super reliable and from what I read, there is some contention that it is helpful. Perhaps you can ask your doctor about her finding and see what she thinks about it. I personally believe that every bit of information is helpful as long as one can weigh it accordingly. Sometimes we can have a variety of tid bits that, although not conclusive all by themselves, can paint a better picture when taken together.

Yes dermoid cysts are actually considered to be the most common form of benign neoplasm so indeed these types of cysts can be called that. Unfortunately, this word sounds horrible when all it means is a new growth.

Your pain is most likely something to do with ovulation. I also had horrible pains around day 15 of my cycle but after they took my cyst out, I STILL had them so they must be mittleschmerz or ovulation pain. Since I had been on the pill most of my life, I had not been familiar with this and I went off the pill around the time they diagnosed the cyst. Try ibuprofen like Advil for this and see if it works for you. Ibuprofen combats the prostaglandins that produce the pain and they can be very effective. Heating pads work well too but you have to be at home for this whereas Advil or Motrin can be taken anywhere. I am not sure is ibuprofen is contraindicated with high blood pressure so please check with your doctor first (I am not a physician so I could not tell you for sure).

Try to stay busy between now and your next appointment. Do some things that you love to do but that perhaps you have not had time for in the past. Plan a get together, go out and buy some music that you used to enjoy when you were younger and that has good memories for you, check out a great movie or read a really good book. In other words, step out of your daily activities and do something special (shopping is allowed !). Keep your mind busy and occupied so that you don't dwell on negative thoughts (these are your worst enemy right now so try to fight them off as best you can).

I wish you all the best at your next appointment .. here's hoping that the cyst will be gone by then. Feel free to check back if you need encouragement. I do know how important this is at times like these (boy do I ever !).

Take care.

Estria

 
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Old 10-05-2009, 05:16 PM   #7
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Re: Complex cyst 4.8 cm

Hi, I too have a complex cyst. I have had it for years...I get ultrasounds every 3 months, along with CA-125 blood tests. This last exam it had changed, which has her slightly concerned, so were awaiting the blood results. Complex means its not all liquid, it has a solid area, and my solid area got larger. I have never had surgery for this, but it might be in my future. My Dr, who I trust alot, says to watch for increase in size....mine hasnt really changed. Dont worry, just go for your 6 week check. They do resolve on their own often, within 6 months. Mine hasnt, and Im alive and kicking! I believe I have had mine for almost 6 years?
Mine causes pain, pretty bad pain during ovulation. Does your hurt?
Take care
Kelly

 
Old 11-03-2009, 07:30 AM   #8
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Re: Complex cyst 4.8 cm

I had my follow up ultrasound on Friday 10/30 and I picked up the report yesterday 11/2 During the test the tech kept entering FF so I asked what that meant-- Free Fluid. I still have the cyst, still noted as complex and slightly smaller.

The report shows "moderate amount of free pelvic fluid- this is new compared to previous scan". What causes this fluid? They also noted small amount of fluid in the endocervial canal??

I have been feeling horrible for a few weeks, a ton of pelvic pressure, pains that come and go, nausea, tired and this unusal pressure on my rectum. It hurts to have my pants buttoned at times and I have gained 6-8 pounds since September.

Still waiting for the doctor to call and discuss...

Any ideas on what I could request for other tests or ????

 
Old 11-03-2009, 06:09 PM   #9
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Re: Complex cyst 4.8 cm

Quote:
Originally Posted by leafy723 View Post

The report shows "moderate amount of free pelvic fluid- this is new compared to previous scan". What causes this fluid? They also noted small amount of fluid in the endocervial canal??
I don't know a whole lot about cysts, and unfortunately can't help with your other questions, but free fluid in the pelvis can be caused by ruptured cysts. I've had a couple internal ultrasounds due to some left sided uterine pain, and was told that the temporary pain I occasionally have is due to pressure from the fluid from the ruptured cysts. Makes sense, since this fluid is usually reabsorbed by your body in a few days, and that coincides with my symptoms -- they come out of the blue, last a few days, and then I'm fine.

I do not know if ruptured cysts can also cause fluid in the endocervical canal. I haven't heard of that as a finding, so unfortunately I can't help you there.

 
Old 11-13-2009, 10:31 AM   #10
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Re: Complex cyst 4.8 cm

Just an update..

I'm scheduled for surgery 11/23. My CT scan showed the cyst and also lesions on my Kidney and Liver. They didn't seem too concerned about the lesions but decided the cyst needs to come out. They will do biopsies of the fluid and whatever else. Also remove any adhesions from previous surgeries.

My CA125 came back at 31 which I thought was perfect but my doctor said that alone needs to have a follow up test. She said because it was the upper limit of normal that she would want to have it done again.

So now that I'm waiting for the surgery day (10 days) I feel somewhat relieved. No more tests for now. I'll have the precedure and should have some answers soon. I think the unknown is the worst part of it all. And, the waiting for test results-errrr...

Thanks for the replies and wish me luck......

 
Old 05-14-2011, 07:45 PM   #11
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Re: Complex cyst 4.8 cm

Saw your post on Healthboards about your ovarian cyst. Please share what happened to you in your surgery?
Thanks!

 
Old 05-15-2011, 08:29 PM   #12
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Re: Complex cyst 4.8 cm

Hi mamaskoby,
I was the original poster of this post, and I ended up having surgery in Feb 2010 for my ovarian cyst. Surgeon ended up removing the left ovary and fallopian tube. The cyst was benign, and turned out to be a endometrioma (chocolate cyst). I also had stage 3 endometriosis and had it excised off of my other ovary,appendix, bowel, uterus, bladder, etc. My bowel was also glued by an adhesion that had moved my bowel several inches out of place.
I have been pain free since the surgery! My right ovary still hurts during ovulation, but thats from the endo, not any cysts.
I wish I had done the surgery earlier, it was a piece of cake!
Kelly

 
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Old 05-16-2011, 05:42 PM   #13
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Re: Complex cyst 4.8 cm

Quote:
Originally Posted by ksc1968 View Post
Hi mamaskoby,
I was the original poster of this post, and I ended up having surgery in Feb 2010 for my ovarian cyst. Surgeon ended up removing the left ovary and fallopian tube. The cyst was benign, and turned out to be a endometrioma (chocolate cyst). I also had stage 3 endometriosis and had it excised off of my other ovary,appendix, bowel, uterus, bladder, etc. My bowel was also glued by an adhesion that had moved my bowel several inches out of place.
I have been pain free since the surgery! My right ovary still hurts during ovulation, but thats from the endo, not any cysts.
I wish I had done the surgery earlier, it was a piece of cake!
Kelly
Glad everything worked out for you! That's great news.

 
Old 06-03-2011, 12:04 PM   #14
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Re: Complex cyst 4.8 cm

Quote:
Originally Posted by leafy723 View Post
Hello-

I'm 41 with a long history of ovarian cysts. In 2002 had a 9cm dermoid removed with most of my left ovary. Have had several functional cyst since. They have been watched and eventually went away.

I have recently had two episodes of severe abdominal pain and after the pelvic ultrasound was told a cyst had burst (I had fluid in my abdomen)- re-check in 6 weeks. My doctor seemed unsure if this one would resolve on its own.
I obtained my report and it shows a 4.8cm complex cyst with internal echos and irregular internal septations. Impression consideration~ hemorrhagic, endometrioma or cystic neoplasm. Also, calicification adjacent to the edometrial stripe. No left ovary could be seen.
Im worried this time more than any other and am wondering if anyone has been through something similar.

 
Old 06-03-2011, 12:11 PM   #15
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Re: Complex cyst 4.8 cm

Hi i have poly cystic ovarian disease and it is similar to what you are saying the cyst are large and when they burst it is very painful. Your doc needs to test you or this disease. I also had Cervical Cancer about 7yrs ago now but had a hysterectomy. They left my ovaries because i was still young. But before the cancer i even had cyst on my ovaries. Also i have had several surgeries to remove the cyst. The last cyst i had on the ovary was 3.5 cm and i had 2 one on each ovary and i think it was the right ovary it was leaking it was painful.So i do understand what you are going through it is tough and ppl dont understand how painful this id till they experience it for themselves.

 
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