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Complex cyst, low malignant potential, whereto from here? Complex cyst, low malignant potential, whereto from here?

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Unread 07-25-2004, 09:21 PM
Complex cyst, low malignant potential, whereto from here?

Hello Ladies

I have had a complex cyst on my Left ovary that has appeared since my first US last May 2003, and has now persisted over three months. When first seen, it was around 2.5 cms, the ultrasound technician today said it had grown a little, but was of low malignant potential.

My gynae has ordered the CA125 but I don't know what the results are.

I am 48 years old, probably perimenopausal but mum wasn't menopausal until 55 years old. I was never able to conceive children, and received several months of fertility drugs which are now both linked to ovarian cancer risk. I was diagnosed with endometriosis in my twenties and while this was treated, I probably still have it. I have no sisters, mother is well but dad died from cancer of the bile duct a few years ago (aged 70). I have a maternal aunt who had ovarian cancer a few years ago and is now OK but under follow up.

I have yet to speak with the Gynae but I have always been concerned about having ovarian cancer - just one of those things, as i don't over concern myself about breast cancer even though I have had a few friends who have it .

I would like to have the ovary removed - the two little words 'low malignant' as opposed to 'no malignant' potential are bugging me. The ultrasound Dr did not seem overly concerned that I should have it removed but then, the last time she didnt tell me the cyst complex until I read it in the report she wrote to the gynae!

Everything I have read said that complex cysts should be removed if they persist. I know mine is small but how many ultrasounds does one have before it gets big enough to remove?

Thankyou to all you ladies out there - I look forward to some of your opinions if you have the time.

Does anyone have an opinion about this?
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Unread 07-25-2004, 10:05 PM
Gynecologic Oncologist

Low malignancy potential calls for surgery and often followup chemo. I'm not sure how the gynecologits can diagnose this as LMP unless it is actually removed and pathology done. If cancer is suspected, the gynecologic oncologist is the expert doctor to treat you. The ultrasound and the CA125 will he;p put a picture together; you may also have a CT scan so they can look a little more. Do ask for a gyn/onc consult!
Unread 07-26-2004, 05:17 AM
Complex cyst, low malignant potential, whereto from here?

s Aussie

The US tech cannot possibly tell the pathology of a complex cyst by looking at US pictures. And if the cyst is of low malignancy potential, a ca 125 is useless.
I agree with you. A complex cyst that persists needs to be surgically removed and biopsied. And like Margaret said, a gyn oncologist is the expert with suspicious ovaries.
Best wishes.

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Unread 07-26-2004, 09:05 AM
Complex cyst, low malignant potential, whereto from here?

Dear Aussieone,

I am going through the same thing you are so I will have surgery in about a week. I have heard that if the cyst is less than 4 cm they wont operate but then considering it is a complex cyst they may. But your doctor wont know anything until they go in there remove it and do a biopsy of the cyst to see what it is. With the CA-125 and the ultrasound it only sheds a portion of light onto the situation. I know with mine they will be doing a vertical laparotomy take the mass out whole along with whatever ovary it is attached to(they couldnt tell on ultrasound) and then do a biopsy of the mass and I should know the results of that a couple of days after. For my self there are a few things it could be a malignant tumor or a benign tumor. On top of that they may need to do a hysterectomy. Because of my high CA-125 levels it could indicate an infection, endo, or cancer so even with the ultraound and the CA-125 levels it may still be benign. So I know how terrible it can be to wait for answers and the pain is very uncomfortable so I am very sorry for the current predicament I hope you get good results and they find the best plan for you please keep me updated. Hoping you feel better and wishing you luck.
Unread 07-26-2004, 06:45 PM
Crowded OR for me I think!

Thankyou Ladies for your time and hugs

I agree with you all! I dont want to wait and see - it is too important for me and every little jerk of pain will have me racing to the doctors - "is it growing?"

I am now seeing my GP on Thursday - she is a very pragmatic kinda lady and will tell me the whole truth - she has had a hyster herself (dont know why - I only learnt this from a colleague) and went through early menopause so she will tell me what I need to hear. So when I get to my gynae I will already have a plan. I suspect that if this means surgery my gynae will refer me on to a gynae/onc who is also in her offices.

At this stage I want it out, but the gynae has said that when she removes ovaries she also generally does a hysterectomy too! I just want to get rid of my ovaries. I think the recovery will be easier without the whole hyster scenario and I believe the symptoms of uterine cancer are easier to pick up. Of course, if they believe it is cancer then the whole lot has to go. And she does not operate on endometriosis - I have to go to an endo surgeon for that.

I can see it now - the gynae will start the operation, she will then hand over to the endo people because i believe that I have some endo patches around the bowel (different symptoms) and then they will hand over to the gynae/onc who will remove the ovary. Could get kind of crowded in the Operating Theatre! Just got to laugh.
Unread 07-26-2004, 06:51 PM
Complex cyst, low malignant potential, whereto from here?

I have a complex cyst and a raised CA 125 Endo , fibriods and more, my Ob/Gyn and Onc/gyn are not fulling around, they will both be at my surgery and I'am having a TAH/BSO Wen morning at 7:30 AM!
Unread 07-26-2004, 07:19 PM
Good luck Princess

Whoa Princess, all the best to you for tomorrow. May I ask the size of the cyst - I think this may be the sticking point for me.

I saw fibroids on the ultrasound yesterday - yep, I have them too like you, but boy, one was really ugly looking - with this kind of projection thingy!! Phew - get it out, now I know why people say they have an alien inside

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