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Old 09-16-2010, 11:46 PM   #1
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Question about ovarian cyst with mural nodule

I have had a paraovarian cyst that has slowing been growing over the past 2 years. Currently, it is 3.3 x 2.2 x 2.6 cm. I had a lot of lower left quadrant pain (which is the side of this cyst) a few days ago and my ob/gyn sent me for a follow up ultrasound to rule out torsion. On this study, it was found that the cyst now has a 3mm mural nodule, which was not there on the prior ultrasounds (one done 2 months ago and one done 3 wks ago.) Also noted was some free fluid and 4 enlarged inguinal lymph nodes (largest two meauring 3.2 cm and 2.4 cm which were 3x and 2x the size they were 3 wks ago, respectively.) Two lymph nodes were visualized on the study 3 wks ago bu there are two new ones, all clustered together. I am 28 years old and the mother of 3 young children, the youngest being 12 months. I have also been losing weight unintentionally and am not able to gain weight at all. I am very fatigued, have some shortness of breath, bloating, and a lot of gas-especially in the mornings. My mother had colon cancer and my father currently has lymphoma. My ob/gyn wants to remove the cyst but said he will not do so until I am evaluated by a general surgeon for the lymph node enlargement, but the soonest the surgeon can see me is in one month. I am nervous leaving everyhing as it is for another month, especially since there has been so much change in the past 3 weeks. What could this all mean? What is a mural nodule? Any advice?? I am so worried, I need to be well for my children.

 
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Old 09-21-2010, 04:28 AM   #2
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Re: Question about ovarian cyst with mural nodule

Hello Lulu,

A mural nodule is a small growth on the wall of the cyst. Usually simple cysts are filled only with fluid and they have thin walls (this can be seen on the ultrasound). Complex cysts have some kind of solid component inside them, such as a calcification (like teeth in a dermoid cyst for example) or some kind of tissue. 3 mms is not that huge but it may change the classification of the cyst from a simple cyst to a complex one and this means that it would have to be taken much more seriously.

Have they done a CA-125 or a CA-19 (I think this is the antigen number but not sure) ? The first is a cancer antigen for ovarian cancer and the second for bowel cancer. The CA-125 is not always accurate in premenopausal women and may give a higher than normal reading even if cancer is not present. However, if the numbers are off the charts, it may indicate a problem. These are simple blood tests that can be done right away so speak to your doctor about this.

Also, if you are uncomfortable waiting, see about getting another opinion from another gynecologist. They may assess your case as more urgent and put you through faster. In the meantime though you may wish to ask for the bloodtests which should only take a few days to get results. When people are as young as you are, doctors tend to discount the possibility of more serious diseases and there is a reason for this. Diseases such as ovarian cancer and bowel cancer occur mostly in older people (over 60). However, if you are having symptoms, you should still rule these things out, just to be on the safe side.

I hope I have been able to help you a little. I also hope that your doctor will take care of this as quickly as possible. In addition to the symptoms that you are suffering with, you are probably also quite anxious to find out what is causing them. This is not a healthy state to be in as I am sure you are aware. Try to hang on and if you need further support, come back and talk. I or one of the other ladies on these boards will be happy to help if we can.

All the best.

Estria

 
Old 09-21-2010, 02:35 PM   #3
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Re: Question about ovarian cyst with mural nodule

I am sorry you are going through this ! I am also a mom of 3 children and all of this is very very scary more so when you have kids ! I have been having pain now for quite sometime. Let me start here. When I was 22 I had surgery done to remove cysts from my left ovary because they were causing me pain also had them on my fallopian tubes. Since then I have had 3 children and I have ALWAYS had problems with cysts. Either coming and staying for quit sometime and then going away or now which is different. I am now 38 and in 2007 had my 3rd child. After I developed a cyst on my left ovary that was 3.8 x 4.4x3.1..my doctor said it looked functional and unless I was having major problems we would just leave it be. So now 3 years later , actually for about a good year now , I have been having symptoms from this cyst. I went and had a CT scan and vaginal ultrasound and today went in for the results with my obgyn. My symptoms have been constant pinching burning sensation in my ovaries , gas , bloating , and burning down my thighs and hips , and lower back pain. This is pretty much daily , some days better than others. So today she said my transvaginal showed that the cyst was 4.8 with a 3 mm mural nodule and it was complex. So her thought was this . My CA125 though not always reliable was 7 which is VERY low. I have trace amounts of free fluid which if it were cancer that is one thing they look for to get worse quickly. My CTscan and ultrasound were done 1 month apart and the fluid remained the same which is a good sign. She also said I have no enlarged lymphnodes..also good. So because of the slow growth she is NOT concerned of cancer but suggested I have it removed including the ovary.
now I am going to re read what you wrote and tell you exactly what my doctor said today because you do have alot of what I have !

 
Old 09-21-2010, 02:41 PM   #4
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Re: Question about ovarian cyst with mural nodule

Quote:
Originally Posted by lulu2008 View Post
I have had a paraovarian cyst that has slowing been growing over the past 2 years. Currently, it is 3.3 x 2.2 x 2.6 cm. I had a lot of lower left quadrant pain (which is the side of this cyst) a few days ago and my ob/gyn sent me for a follow up ultrasound to rule out torsion. On this study, it was found that the cyst now has a 3mm mural nodule, which was not there on the prior ultrasounds (one done 2 months ago and one done 3 wks ago.) Also noted was some free fluid and 4 enlarged inguinal lymph nodes (largest two meauring 3.2 cm and 2.4 cm which were 3x and 2x the size they were 3 wks ago, respectively.) Two lymph nodes were visualized on the study 3 wks ago bu there are two new ones, all clustered together. I am 28 years old and the mother of 3 young children, the youngest being 12 months. I have also been losing weight unintentionally and am not able to gain weight at all. I am very fatigued, have some shortness of breath, bloating, and a lot of gas-especially in the mornings. My mother had colon cancer and my father currently has lymphoma. My ob/gyn wants to remove the cyst but said he will not do so until I am evaluated by a general surgeon for the lymph node enlargement, but the soonest the surgeon can see me is in one month. I am nervous leaving everyhing as it is for another month, especially since there has been so much change in the past 3 weeks. What could this all mean? What is a mural nodule? Any advice?? I am so worried, I need to be well for my children.
I will tell you that my obgyn told me that a 3mm nodule is very small and it is also common and she was not worried about it. I think you are having enough symptoms that warrant you either getting a second opinion or more work up . I know its scary and its all you think about because that is what I am going through. I am now having bowel issues and need to see the Gastro doctor BEFORE I have the surgery so one more thing to think about. Not fun !

 
Old 09-21-2010, 04:54 PM   #5
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Re: Question about ovarian cyst with mural nodule

lulu2008

I would try calling the ob/gyn back and leave a message that the earliest available appointment for the general surgeon is one month and you feel that this is not acceptable. Request that he intervene on you behalf and request an urgent appointment. Was this appointment made by the ob/gyn office staff or were you just given the name and told to schedule an appointment? The other option is to call the surgeons office explain the situation and see if they have a cancellation list. I did this when my primary care doctor's office referred me to a neurologist. The appointment they made for me was also 4 weeks away. I called the neurologist's office directly the next day, inquired about a cancellation list. This office has such a list and they actually got a cancellation for the next day, which I immediately took.
I know how it is to have to wait--I hope you are able to obtain an urgent appointment and get the opinion that is required so that you can have the ovary removed.
Let me know how you are doing.
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Old 09-21-2010, 08:40 PM   #6
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Re: Question about ovarian cyst with mural nodule

Thank you for your replies! I didn't get a chance to update earlier..here goes. So Friday afternoon my ob gyn called me and said he wanted me to go to the lab that he was ordering some STAT tests. So I went and he had ordered an ANA, SED Rate, CBC w/ diff, Met. Panel, RH factor, and Lyme Disease antibodies. I guess he wanted to rule out an infection (due to the lymph nodes being enlarged.) I asked him to fax a copy of my ultrasound report to the general surgeon and her nurse called me that same day (Friday.) The surgeon was not in the office but wanted me to fax all of my prior medical records to her office and she said she'd get back to me on Tuesday (today) because she only works in the office Tues and Thurs. So today she called and said seh reviewed everything and wants to see me this coming Tues. I asked her if it was for a consult or a procedure/test and they said it was for a consult and that she'd go over everything w/ me then. So now I need to call my ob/gyn tomorrow and just ask him about when he wants to do the surgery. I also want to know what he is thinking it may be. With my mom's history of colon cancer and my dad's history or lymphoma I am a bit freaked out about this. I just want answers. I did have a CA 125 done about 2 months ago, before the cyst contained a nodule and it was 8 (normal.) I have never heard of the bowel cancer test, maybe I will ask for that one...thank you all again!

 
Old 09-22-2010, 04:11 AM   #7
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Re: Question about ovarian cyst with mural nodule

Hi Lulu,

The CA-19-9 or whatever the number is, is not necessarily strictly for bowel cancer (otherwise we would all get off of having to have a colonoscopy every ten years starting at age fifty and wouldn't THAT be nice). It is however, an indicator for things to do with the digestive tract so it is probably not a bad idea to have that done.

Definitely enlarged lymph nodes could mean an infection of some kind but you should insist that all of the bases be covered, including taking a look a some unlikely causes, just in case. Better safe than sorry.

Take care and let us know what the doctor says.

Estria

 
Old 10-22-2010, 06:57 AM   #8
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Re: Question about ovarian cyst with mural nodule

Hi Lulu

Was hoping you were doing well and could post an update on what you have found out since your last post ?! I am scheduled for surgery on Dec 3rd

 
Old 10-22-2010, 03:55 PM   #9
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Re: Question about ovarian cyst with mural nodule

Hi,

Sorry I didn't update, I am having surgery next Wednesday. My most recent ultrasound showed the 3mm mural nodule still there but now there is blood supply going to the nodule. I still have enlarged inguinal nodes (about 5 of them) so a general surgeon is assisting my ob/gyn and she will remove a lymph node at the same time as my ob/gyn is removing the cyst. I went to sign consent forms today and now he wants to also remove my ovary and possibly the other one. I don't know what to do, I am waiting a call back to ask him why the ovaries because I am not certain I am done having kids. He also wants to do a hysteroscopy and possibly a d&c at the same time. I am so nervous, this is my first surgery and I want to make sure I come out of it okay!

 
Old 10-22-2010, 04:15 PM   #10
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Re: Question about ovarian cyst with mural nodule

Hi Lulu,

Why the heck does he want to do a hysteroscopy and a D & C ? I thought that your symptoms were a paraovarian cyst and enlarged lymph nodes. Is there something wrong with your uterus as well ? or are you having irregular bleeding issues perhaps ? I don't understand.

I think you are right to be clear with your doctor about your ovaries. Have you been given a CA-125 test yet ? If so, what was the result ? If they suspect ovarian cancer at all, they should call a gynecological oncologist and not just have a gynecologist do the procedure. Cancer is unlikely but if they are at all suspicious, they should have a gyne oncologist do the procedure. A CA-125 would give more information before the surgery. Your ovaries should only both be removed if there is no other choice. If they have been destroyed by the cyst or if ovarian cancer is present. Otherwise, they should try to save at least one of them. This is not just because of your wish to have more children (which is also very important) but also because of hormonal balance. Without your ovaries you will be kicked into surgical menopause and you will have to probably supplement with synthetic or bioidentical hormones. This is not a decision to be taken lightly and your doctor absolutely needs to discuss this with you.

Be very clear with him about your wishes and about not wanting to have any unnecessary procedures done. Obviously taking one of the enlarged lymph nodes is a good idea and removing the cyst (and one of the ovaries if necessary) also, but the other procedures don't sound like things that have anything to do with your symptoms (unless something showed up on scans) so find out why the heck your doc wants to perform them.

I am sure that you will be well taken care off at the hospital on Wednesday. Try to eat well and get enough sleep in the meantime. Also, make sure that you clarify what medication is OK and what isn't for the surgery so that you don't have any unnecessary drugs in your system.

Take good care of yourself. You will be in our thoughts.

Estria

 
Old 10-22-2010, 09:03 PM   #11
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Re: Question about ovarian cyst with mural nodule

Estria,

Thank you for your reply. I am wondering the same things, honestly. I have a call and an email put in to him and am hoping to hear back by Monday. I went to sign consent forms today and the surgical coordinator was the one I spoke w/..the doctor was in surgery. I think he is thinking of doing the hysteroscopy to take a look around and to make sure there aren't any polpys or anything, I have had a few episodes of thickened/cystic appearing endometrium on ultrasounds but the endo. biopsy was fine. I am still nursing my 14 month old so I think hormonally, my body is still out of whack. As for the ovaries, I can see him possibly needing to take the left where the cyst is by but why the right? That is one of my questions for him. I had a CA 125 about 3 months ago, before the mural nodule and blood flow appeared in the cyst and it was 7.

 
Old 10-23-2010, 10:27 AM   #12
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Re: Question about ovarian cyst with mural nodule

Hi Lulu,

Yeah you are absolutely right to get things straight before they go in. Sometimes these doctors try to get in a few "extra" procedures to pack the pocketbook a little, if you know what I mean. Just make sure he does only what is necessary because every additional thing is more risk for you. That being said, the procedures are not considered major surgery (and this is why sometimes the docs add a couple of other things because they think it won't matter) but surgery of any kind is surgery and should not be taken lightly. The sooner we start to put our foot down as patients the sooner doctors will learn to not only inform us of what is going on but also understand that the ultimate decision to have surgery is no one else's but OURS.

I am sure that all will go well for you. If you have any question post surgically, don't be afraid to come back and ask. Sometimes it helps to talk to someone who has gone through the procedure. Mine was a laparoscopy (ie. so called keyhole surgery) to remove my left ovary and a cyst. There are other ladies on these boards who have had a myriad of procedures who I am sure can chime in with their own experiences. These boards are wonderful for this.

All the best and speedy recovery.

Estria

 
Old 11-23-2010, 04:33 PM   #13
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Re: Question about ovarian cyst with mural nodule

How did your surgery go ?! I go next week and I am so scared. It would be nice to talk to someone who had it done recently . Hope everything went ok .

 
Old 11-23-2010, 04:48 PM   #14
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Re: Question about ovarian cyst with mural nodule

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Originally Posted by momoftrio View Post
How dd your surgery go ?! I go next week and I am so scared. It would be nice to talk to someone who had it done recently . Hope everything went ok .
It was so easy! I was absolutely terrified as it was my first time having general anesthetic and first surgery. I basically went there, had my vitals and stuff monitored and after I spoke with the doctor and anesthesialogist I was given some Verced in my IV and wheeled into the surgical suite. I felt sleepy and things looked fuzzy and that is all I remember. When I woke up the nurse was trying to get me to drink soda because I had low blood suger (I have hypoglycemia) and I felt totally fine, just very sleepy. After that I went home and I had pain in my right shoulder and chest from the gas (I had multiple things done at one time, the cyst removal, a diagnostic lap. to look for endo, a hysteroscopy, tubal dye study, and a d & c) so I had a lot of gas put into my pelis and abdomen. My incisions felt totally fine which I later learned was because the doctor gave me an IV anti inflammatory med, forget what it was called. The next day I felt sore when getting up and sitting down due to my belly button incision and had more pain from the gas, which a heating pad, laying flat, and maalox max helped. I was able to attend my daughter's school play and halloween parade less than 24 hours after surgery, I was just sore. The next day I felt much better but was bit by a brown widow spider and started my period in the same day, so that made me feel crappy, but the incisions were just barely sore. I didn't have any bruising and my incisions were healed one week later. It was super easy and I am so glad its all over, I was worrying so much for nothing. Good luck!

 
Old 11-23-2010, 04:54 PM   #15
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Re: Question about ovarian cyst with mural nodule

Quote:
Originally Posted by lulu2008 View Post
It was so easy! I was absolutely terrified as it was my first time having general anesthetic and first surgery. I basically went there, had my vitals and stuff monitored and after I spoke with the doctor and anesthesialogist I was given some Verced in my IV and wheeled into the surgical suite. I felt sleepy and things looked fuzzy and that is all I remember. When I woke up the nurse was trying to get me to drink soda because I had low blood suger (I have hypoglycemia) and I felt totally fine, just very sleepy. After that I went home and I had pain in my right shoulder and chest from the gas (I had multiple things done at one time, the cyst removal, a diagnostic lap. to look for endo, a hysteroscopy, tubal dye study, and a d & c) so I had a lot of gas put into my pelis and abdomen. My incisions felt totally fine which I later learned was because the doctor gave me an IV anti inflammatory med, forget what it was called. The next day I felt sore when getting up and sitting down due to my belly button incision and had more pain from the gas, which a heating pad, laying flat, and maalox max helped. I was able to attend my daughter's school play and halloween parade less than 24 hours after surgery, I was just sore. The next day I felt much better but was bit by a brown widow spider and started my period in the same day, so that made me feel crappy, but the incisions were just barely sore. I didn't have any bruising and my incisions were healed one week later. It was super easy and I am so glad its all over, I was worrying so much for nothing. Good luck!
You made me feel so much better ! I am so glad everything went smooth for you and you are feeling good ! I will post to you when I get back on Friday after surgery and let you know how I did ! I Hope they are just going to remove my left ovary and the cyst and that nothing else needs to be done , but it soundslike they did so much to you just through the laparoscopy so That is great news !! Thanks for replying and I will talk to you soon !

 
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