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Have complex cyst. Waiting eight weeks to check before surgery. Are these usually cancerous?

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OBGYN, Gynecologic Oncology
Practicing since : 1984
Answered : 99 Questions
Hi, I was diagnosed with a 5 cm complex cyst and referred to a gynco oncologist. The gyno oncologist read the report from the other doctor (regular gynecologist) and also did a quick exam and said I could wait 8 weeks and check again or have surgery. I chose to wait 8 weeks. The cyst has a thin septation in it and some debris. Are these usually cancerous? I went back 3 weeks later and it is now 4.6cm. Is it likely getting smaller or can that be within the margin of error measuring a cyst?
Posted Fri, 21 Sep 2012 in Head Injuries
Answered by Dr. Manjunath L Ramarajapalli 2 hours later

Thanks for posting your query.

There are some functional ovarian cysts in a woman of reproductive age group [woman having menstrual function].

During every menstrual cycle a follicle [egg] develops and ovulates [ruptures] releasing an egg.
Sometimes this egg will not rupture causing functional cyst. Usually it disappears after some time.
For this reason, unilocular cysts up to 8 cm size are watched for 2 to 3 cycles. That is the reason your gynec-oncologist advised you to wait for 8 weeks [although cyst has thin septation and debris].
The cyst maybe getting smaller as shown during second visit.

Hope this helps you. Do let me know if you have more concerns.

Good luck
Above answer was peer-reviewed by
Follow-up: Have complex cyst. Waiting eight weeks to check before surgery. Are these usually cancerous? 2 days later
Just some additional information. I am 37 but I am in menopause since age 19 (due to a cyst is not related to a typical monthly menstrual cycle. I am on HRT (Vivelle DOT and prometrium). At age 14 I did have a large cyst (literally the size of a basketball) that was removed through laparoscopy. It was found to be a benign mucous cystadenoma. I have attached the report from the 7/24/12 ultrasound. It does indicate at the bottom that the cyst has decreased slightly (from 5cm to 4.6 cm). Again, I don't know if this is a true decrease or within margin of error for measuring. The cyst size seems large to me. Is this considered a large cyst? Although it says complex, I saw the cyst on ultrasound and had an in depth conversation with the sonographer about it. She said it had thin walls, still looked mostly fluid with what looked to me as some small fine sand-like particles floating within the fluid (she called this debris). Then there was a small thin line in it that she called a septation but the cyst had not actually separated.
In April 2012 a simple cyst was noted that measured 3.5cm and follow up was recommended. This resulted in my 7/5/12 visit showing a 5cm cyst and then again another ultrasound on 7/24/12 showing the cyst at 4.6cm. Is it likely this simple cyst has turned complex or could this complex cyst be different from the original simple cyst? Can simple cysts turn cancerous? I appreciate you answer my questions and please excuse the many questions as I am very worried about cancer due to my chronic myelogenous leukemia and bone marrow transplant when I was 19 years old. I think I have developed some type of medical PTSD where I think everything is cancer. Please see report attached. Thank you.
Answered by Dr. Manjunath L Ramarajapalli 16 hours later
Thank you for giving information of your illness at the age of 19 and 14.
I understand you are on HRT since that time.If HRT has been taken irregularly at any time,may cause ovarian cysts [by releasing FSH and LH hormones and stimulating ovarian tissue]
Ultrasound report of 7/24/12 may be showing real decrease of size or error of measuring.
Simple cysts are usually not cancerous.
Your previous history of bone marrow transplant and leukemia probably has no relation to present problem [I have discussed with my medical oncology colleague].
I advise you to wait for some more time for the things to resolve.
Good luck
Above answer was peer-reviewed by
Follow-up: Have complex cyst. Waiting eight weeks to check before surgery. Are these usually cancerous? 10 hours later
Thank you for your reply. You state in your last reply that simple cysts are usually not cancerous.
The cyst I have now on the 7/5 & 7/24/12 ultrasounds is complex. The one I had in April 2012 was simple. I just wanted to make sure you knew my current cyst causing me concern is not a simple cyst but is a complex cyst. Are you saying simple cysts are usually not cancerous because you are explaining that even though this cyst started as a simple cyst in April 2012 and has now turned into a complex cyst, that simple cysts do not usually turn into complex cysts that are cancerous?
Answered by Dr. Manjunath L Ramarajapalli 23 minutes later
I understand your concern.
The cysts either simple or complex are to be ultimately examined by the pathologist to determine whether they are cancerous or not.
As clinicians we say the probability/percentage of they being cancer or not is based on some factors.
So you can wait for some time or get the cyst removed to resolve the issue.
Good luck
Above answer was peer-reviewed by
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