Ovarian Cyst - next steps?

Patient

Q: Diagnosed via transvaginal ultrasound with 3.5cm complex multi-septated ovarian cyst. Ca-125 result: 7. Gyno scheduled another ultrasound in 8 weeks, but I don't know that I can tolerate the symptoms until then & don't feel comfortable waiting. Family history of ovarian, bowel, & bladder cancers. At what point is it prudent to request to see a gynecologic oncologist? I want to rule out ovarian cancer.

Symptoms:  Pain (ovarian, pelvic, abdominal, hip, back); significant bloating, gassiness, heartburn/indigestion; numbness/tingling (leg).
Doctor

A:   Hello,
If you have been diagnosed with a 3.5 cm large complex ovarian cyst with septations, then it is imperative to rule out ovarian carcinoma in the next step. It is important to get tumor markers done--namely, CA 125 ( which is 7 and is non malignant range), CEA, AFP, and BETA HCG levels. Ideally if CEA and CA125 are not raised, then the cyst is unlikely to be a carcinoma of the ovary. Also, important next step would be is to get an MRI SCAN done see the thickness of the septations, if they are thicker and not thin, then chances of ovarian carcinoma can be a possibility.
The cyst needs to be followed for growth as well, so if you can manage a USG 2 weekly then the growth or stability of the cyst can be ascertained. IF there is no further growth, then the cyst is benign and can be removed easily laparoscopically performing a cystectomy. You may discuss the options with your physician and take an informed decision.
I hope i have answered your query in detail,
wishing you good health,
regards

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