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Malignancy test for ovarian cyst - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Vaginal and Uterus Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2495 Questions
User :   I am a 61 year old, no pregnancies, who has ovarian cyst. The cyst has looked simple until last Ultrasound which shows now 3 daughter cysts and one papillary projection. Cyst is not 3.4cm. Is this a good indication of cancer?
Doctor :   Hi
Doctor :  
Let me read it
Doctor :   Ok

User :   What do you think?
Doctor :  
With an ultrasound, it is not possible to tell about the possibility of a cancer
Doctor :  
and you should not worry in that line
User :   But from everything I have read this sounds like a classic case.
Doctor :   Ok

Doctor :  
Did you meet the gynec with the report?
User :   Yes
User :   I did not get and answer. He just said it needed to come out. I guess I am wanting to hear some kind of an answer.
Doctor :   Ok

Doctor :  
Cysts are common in benign conditions
User :   I must admit....I am scared to death.
User :   I am a registered nurse and of course we know a little about this stuff.
Doctor :   Ok

Doctor :  
First of all there is no need to be feared of it as a cancer
Doctor :   Most ovarian cysts are functional in nature, and harmless
User :   Why not?
User :   But I am post menopausal.
Doctor :   Ok
User :   I have had no pregnancies. Those are high risk factors
Doctor :  
Do you have a family history of the same?
User :   No
User :   Doesn
Doctor :   Ok

Doctor :  
Have you had supporting symptoms?
Doctor :  
like loss of weight, cachexia, loss of appetite
User :   doesn't papillary projections usually indicate malignancy.
User :   I have no symptoms.
Doctor :  
Ok
User :   They have been following this cyst for over a year and it has just changed in the last ultrasound
Doctor :  
I shall explain you
Doctor :   Have you had ascites done?
Doctor :   Sorry

User :   I know what ascites is but what do you mean done
Doctor :  
Have you had ascites, meaning collection of fluid in the abdomen
User :   No
Doctor :   Yes

Doctor :  
that is the reason I said sorry
Doctor :  
I typed it wrong
Doctor :  
Sorry again
User :   My CA-125 is 15.
Doctor :  
And did your gynec advise you any other tests for the same?
User :   What type of test. He just advised surgery
Doctor :  
Blood tests
Doctor :  
CA 125
Doctor :  
which is an indicator
User :   I had CA 125
User :   it was 15.
User :   Last year CA 125 was 24
User :   CA 125 is not a very good indicator though, is it?
User :   Hello, are you still there?
Doctor :   Hi
Doctor :  
Yes CA 125 is not a good indicator
User :   So what should I think?
Doctor :  
but for a predictive point
Doctor :  
confirmation could be done laparoscopically
User :   Based on what I have told you....should I be really concerned about malignancy. I really need a true answer.
Doctor :   No

Doctor :  
You should not
Doctor :  
it shall be a very premature conclusion
User :   I guess I am wondering why not.
User :   I read all the information on the internet and everything points to malignancy.
Doctor :   How has the size changed over time?

User :   It has been 2.4cmX1.8cm for over a year but in the last ultrasound it was 3.8 x 2.4cm
Doctor :   Ok

User :   I am sorry 3.4 x 2.4cm
User :   1 papillary projection.
Doctor :  
The one thing which favors a malignant one is that papillary projection
Doctor :  
but cannot be a confirmatory diagnosis with that
Doctor :  
Thats why your gynec has also done the saem
User :   yes I know. That is what concerns me. Are all ovarian papillary projections malignant or are some benign.
Doctor :   Papillary projections does indicate a bit of activity

Doctor :  
and now the confusion is like
User :   meaning?
Doctor :  
what activity it is
Doctor :  
is it a functional one
Doctor :  
or a malignant one
Doctor :   I would suggest you to take the help of our Oncologist

Doctor :  
He shall be able to guide you better
User :   can ovarian papillaries be benign.
Doctor :   It is out of my scope to comment on it

User :   Yes I have an appt with one. But just very frightened.
Doctor :   Ok

User :   My I ask your medical speciality.
Doctor :  
No need to be
Doctor :  
I am a General Practitioner
User :   Cancer is a ver scary thing.
Doctor :  
Yes, it is
Doctor :  
But do you know
User :   I suspect
Doctor :  
Cancer is curable but not Hypertension or Diabetes
User :   I did not think Ovarian Cancer was curable.
Doctor :   At early stages

Doctor :  
if excision is done
Doctor :  
it is
Doctor :  
but what happens is ovarian cancers are more silent
Doctor :  
and that shall make it be diagnosed late
Doctor :  
and hence poor prognosis
User :   I would hope it this is malignant, that it is early stages because we have been watching it.
User :   I have not symptoms.
Doctor :   Ok

Doctor :  
Dont even hope for that
Doctor :  
I hope it to be benign
Doctor :   A histopathology is the confirmatory one

Doctor :  
at last
User :   I do hope that. But you know we nurses are.
User :   how we nurses are. A little knowledge is harmful.
User :   I am planning on having robotic surgery as soon as possible.
Doctor :  
Yes
Doctor :  
Ignorance is a bliss
User :   There is no such thing as ignorance with all the stuff floating around the internet.
Doctor :   Correct

Question is related to
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