I am a 40 year old, pre-menopausal woman:
On Sunday (about day 5 of my period) I innocently went to the bathroom. When I was done, instantly I developed severe lower abdominal pain. It was gassy, crampy, and very persistent. Sitting and lying down made it worse, it was awful. Monday morning I couldn't take the pain anymore so I went to the ER. They did a cat scan which showed up negative except a right ovarian cyst so then they proceeded to do a pelvic ultrasound and here it is:
PELVIC ULTRASOUND WITH DOPPLER 10/1/2012 11:28 AM
HISTORY: Right lower quadrant pelvic pain.
FINDINGS: Transvaginal images were performed to better evaluate the
patient's uterus, ovaries and endometrial stripe.
The uterus is retroflexed but normal in size measuring 7.8 x 3.1 x
4.1 cm. No fibroids are evident. Endometrial stripe measures 4 mm and
is normal for patient's age. Nabothian cyst is noted in the cervix
which is within normal limits. The right ovary measures 6.1 x 4.3 x
5.4 cm and contains a complex appearing cyst with low-level internal
echoes measuring 5.3 x 3.7 x 5.1 cm. No abnormal color Doppler flow
is present within this complex cystic lesion. The left ovary measures
4.0 x 2.3 x 2.2 cm and contains a simple appearing follicle or cyst
measuring 1.3 cm. Color Doppler waveform analysis demonstrates normal
arterial waveforms within each ovary. No adnexal masses are present.
A small amount of free pelvic fluid is present.
IMPRESSION:
1. Large complex appearing right ovarian cystic lesion is present
with a small amount of free pelvic fluid. A large endometrioma or
hemorrhagic cyst are possible. Followup ultrasound in 2 or 3 months
could be performed to assess for interval resolution.
2. Dominant follicle left ovary measures 1.3 cm.
3. Uterus and endometrial stripe appear normal.
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I ended up seeing my gynecologist on Tuesday morning still feeling sore and gassy and in pain but not like I did so severely on Sunday and Monday where I couldn't even sit properly or lie down properly due to the pain. He was not concerned at all with this pelvic ultrasound, he said things looked benign and cancer would be very very rare. The plan was to get another ultrasound in two months, then at the last minute I asked if he could run the CA125 blood test so he did.
Got a call from him today and he said he was a bit concerned because the result was 180:
Component Your Value Standard Range Units
CA 125 180 0 - 30 U/mL
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He said this still probably doesn't mean cancer but it's definitely showing we need to prove that it isn't or something like that. I was very nervous and upset while hearing this. I will meet with him and his partner in two days to discuss.
My questions:
1. What does my pelvic ultrasound truly show? Does it look as benign as I thought it did?
2. What could have caused me to have such severe pain with this cyst on Sunday, severe pain, barely able to move and walk with it, then it stayed like that through Monday night but the intense pain eased up Tuesday morning with a more tolerable pain level but still gas, some pains and diarrhea and still there today?
3. Could whatever caused the acute pain on Sunday have affected and elevated the CA125 level due to the acute process if that makes sense? Like I said something big time in an acute way hit me Sunday with this cyst, then as you see I had the ultrasound Monday, and the CA125 took place Tuesday. By Tuesday I could sit up and lie down fairly normally, and even if now I am still left with gassy pains that come and go, diarrhea, and some slight twinges of pain. Sunday and Monday though I could barely sit up or lie down, I was in so much pain. Could whatever happened to me acutely Sunday have caused the elevation of the CA125?
4. Can a benign cyst in itself (if it is benign) cause an elevation of the CA125?
5. Is 180 super high for a CA125?
I am very concerned about all of this now.
