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Ovarian Cancer (Expert Forum)
Complex Ovarian Cyst
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.
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Complex Ovarian Cyst
by lactac1224, Jul 06, 2006 12:00AM
Hi, I am 36 years old and six years ago I was diagnosed with a dermoid tumor and had it, my left ovary and tube removed during a laparotomy. I have now been diagnosed with a 5 cm complex ovarian cyst on my right ovary. The cyst is fluid filled with debris and a solid component. I have had a follow up ultrasound after 4 weeks and the size is the same (a second cyst went away during this time).
The doctor who did my first surgery would not consider a laproscopy because of the risk of cancer. (That was a dermoid and I was told before the surgery that is was only a 1% chance it would be cancer.) This doctor wants to start with a laproscopy to see what the cyst looks like.
My questions are, which procedure is better? Has technology changed that much in the last 6 years? Should I consult with a gyn/oncologist before the surgery? What are the chances that a complex cyst is cancerous? Should I be concerned about scar tissue since I have had 3 other abdominal surgeries and does that effect what type of surgery you should have?
Thank you for any info you can give. The doctor who diagnosed the cyst does not do surgery so I will need to find someone soon.
The doctor who did my first surgery would not consider a laproscopy because of the risk of cancer. (That was a dermoid and I was told before the surgery that is was only a 1% chance it would be cancer.) This doctor wants to start with a laproscopy to see what the cyst looks like.
My questions are, which procedure is better? Has technology changed that much in the last 6 years? Should I consult with a gyn/oncologist before the surgery? What are the chances that a complex cyst is cancerous? Should I be concerned about scar tissue since I have had 3 other abdominal surgeries and does that effect what type of surgery you should have?
Thank you for any info you can give. The doctor who diagnosed the cyst does not do surgery so I will need to find someone soon.
Doctor's Answer
by Annekathryn Goodman, M.D., Jul 06, 2006 12:00AM
, Jul 06, 2006 12:00AM
Hi There,
Your question reminds me very much of one I answered on laparotomy vs laparoscopy. I refer you to that answer from 7/5/2006. I reviewed the issues of when to do a laparoscopy versus a laparotomy. It sounds like with your three previous abdominal surgeries, I would lean towards a laparotomy. Mesh in and of itself would not alter my decision of laparoscopy vs laparotomy. It is possible to go through the mesh or find a different location for the initial laparoscopic incision.
However, ultimately you have to rely on your gynecologic surgeon's recommendations because a recommendation in the absence of personally doing a pelvic exam and reviewing the actual films, is only half a recommendation.
Most cysts are benign but there is no preoperative tests that will definitively let us know. I know it is a horrible anxiety until you know for sure. For an unchanging 5 cm complex cyst, either a general gynecologic surgeron or a gyn oncologist would be fine. Please let me know what happens.
Your question reminds me very much of one I answered on laparotomy vs laparoscopy. I refer you to that answer from 7/5/2006. I reviewed the issues of when to do a laparoscopy versus a laparotomy. It sounds like with your three previous abdominal surgeries, I would lean towards a laparotomy. Mesh in and of itself would not alter my decision of laparoscopy vs laparotomy. It is possible to go through the mesh or find a different location for the initial laparoscopic incision.
However, ultimately you have to rely on your gynecologic surgeon's recommendations because a recommendation in the absence of personally doing a pelvic exam and reviewing the actual films, is only half a recommendation.
Most cysts are benign but there is no preoperative tests that will definitively let us know. I know it is a horrible anxiety until you know for sure. For an unchanging 5 cm complex cyst, either a general gynecologic surgeron or a gyn oncologist would be fine. Please let me know what happens.
I have mesh that was put in for a repair of a hernia behind my bellybutton. Would this make a difference in what type of surgery I can have?
Other than completeing the prescription and following up with the GYN, what else can I do?
I am concerned because I am only 23 yrs. of age and I don't feel the GYN is giveing me the entire story. She sounds like she doesn't believe that I am experiencing discomfort in the same region as the cyst or that I don't know my own body. I have had to do all the research by myself. I feel that the GYN should be telling all of my options and should be more atuned with my patient history that I am giving her.