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Scared to death... complex ovarian cyst with elevated CA125

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Old 10-03-2012, 07:21 PM   #1
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Scared to death... complex ovarian cyst with elevated CA125

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:


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.

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.


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


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.

Last edited by ClevelandEuc; 10-03-2012 at 10:29 PM.

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Old 10-03-2012, 09:55 PM   #2
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Re: Scared to death.. complex ovarian cyst with elevated CA125

The severe pain you experienced was most likely caused by a rupture of a part of the cyst. That is evidenced by the free fluid in pelvic cavity on ultrasound. That fluid irritates the abdominal lining, causing pain, particularly with movement. It usually subsides over 2-3 days as the fluid gets absorbed and the irriation subsides. A complex cyst means it is a mixture of cyst (membrane filled with fluid like a balloon) and a solid part. Your cyst probably has compartments in it like rooms in a house, and only one compartment ruptured, leaving the rest of the cyst intact. A cyst can cause elevated Ca-125 levels. The fact that the cyst has noraml appearing blood flow to it is encouraging. It could be a Chocolate (hemorrhagic) cyst from endometriosis. Any history of that would be pertinent. Usually 5 cm cysts or larger are considered for surgical removal. Complex cysts are more concerning than simple cysts (like one balloon filled with fluid and no solid components.) Given the size, the complex nature of cyst and elevated CA125, my guess is they might recommend removal to be on safe side and get pathology tests done. I cannot answer your last question, but this is high enough to be concerned and not take chances. There is a good chance however, that this cyst is all benign and your CA125 will come back to normal after cyst is gone. It is good you asked for this test, but it can be elevated in benign conditions, so is not diagnostic of ovarian cancer alone. Good luck with your meeting and treatment!

Old 10-04-2012, 07:19 AM   #3
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Re: Scared to death.. complex ovarian cyst with elevated CA125

Thanks. That makes sense. I actually am going to see my gynecologist/his partner at 1:15 today so thankfully it's sooner than tomorrow. This is just so weird to me because the ultrasound report and cat scan report didn't seem serious yet that CA125 is totally elevated. I also still have not felt well.. whatever happened to me Sunday was terrible. Severe pains. I think you are right, something ruptured or leaked. I couldn't sit or lie down properly without severe pain. When I walked I had to hold my abdominal area, it hurt so badly. Tuesday that horrible pain lifted but I'm still now left with severe gas pains that come and go, major water diarrhea (no idea why that's happening) and an achy feeling in the abdominal area. I wonder if this acute process is what caused the rise in the CA125? I also keep reading that ovarian cancer is the "silent killer" so typically you do not have acute situations like this one. I just want to know what's going on, I'm so depressed over this.

Last edited by ClevelandEuc; 10-04-2012 at 07:21 AM.

Old 10-04-2012, 06:52 PM   #4
Join Date: Oct 2012
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mizslynnm HB User
Re: Scared to death.. complex ovarian cyst with elevated CA125

Hey.... I know what you're going through. When I was 13 years old I had severe cysts on my ovaries, and one night, a cyst that was nearly 2 inches big (basically covering my entire ovary), made me EXTREMELY sick, and I had to go to the ER and almost immediately had to have surgery to get it removed. The solution to this? Birth control!! I was put on a birth control shot that I have to get every 3 months that controls the cysts. I don't get cysts at ALL anymore. Wanna know what's even better? I don't get my period anymore either (:. It's a perfect solution. I know that this post was made months ago, but if your gynecologist hasn't already recommended this solution, and you're still having pain from ovarian cysts, then you should definitely go on birth control!

Last edited by Mod-S4; 06-10-2013 at 09:31 PM.

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