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Complex adnexal ovarian cyst

Patient: I had a pelvic and transvaginal ultrasound which reads the following: left ovary has cyst 9 x 8 x 9 mmOther findings: Right adnexal, compressible, well circumscribed complex collection- 7.8 x 3.5 x2.3 cm, containing vascular septations. No pain.Opinion: complex right adnexal collection with vascular septations, this may be in keeping with a peritoneal inclusion cyst- has patient any history of PID or endometriosis? Follow up MR recommended to better evaluate collection.I have no history of anything. Had a MIRENA IUD removed in January 2014. I am very worried about this and want to know what the chances are of ovarian cancer. Thank you.

 

 

Symptoms: Minor pelvic pain

 

 

Doctor: Hello,Thanks for the query to askthedoctor.com for an opinion.The ultrasound pelvis and abdomen indicates a small o varian cyst on the left side less than 1cm in size, which is normal and likely to be a follicular cyst and not the causes of concern, but a large right adnexal mass of size 7.8 x 3.5 x2.3 cm with internal septations which appear to be vascular on ultrasound which appears more like a complex cyst of the right ovary. The possibilities can be either an endometriotic or hemorrhagic cyst or probably a complex cyst with thick internal separations suspicious of an ovarian malignancy. The MRI is hence definitive in diagnosis and establishing the contour differences and also tumour markers like CEA, CA-125, AFP and Beta HCG would be required to differentiate from other differential diagnoses against the possibility of ovarian malignancy.A raised levels of tumour markers and confirmed thick separations on MRI would confirm an ovarian malignancy ( which is also suspected if there is a rapid growth in the size of the cyst over few months ). It would then require a surgical staging of the disease with either a laparoscopic or an open surgical approach. If the levels are normal, then it is more likely to be an endometriotic or hemorrhagic cyst which can then be removed with a laparoscopic approach.You may consult your physician with reports and discuss in details to take an informed decision.I Hope I have answered your query in details,Wishing you good health,Regards

 


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Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji completed his residency in Family Medicine at the University of Manitoba. He currently operates a walk-in-clinic in downtown Toronto.

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