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Suggest Treatment For Hemorrhagic Cyst And Fibroid In Uterus

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Posted on Mon, 15 Jun 2015
Question: Hi there! I am completely confused on how to procede. I am a 41 year old, healthy female (in very good shape, eat well, fit etc...). I feel completely healthy and fine. I have routine sonograms (every other year) to check in on my ovaries, as we have ovarian cancer in my family (not a lot, but enough to make me nervous). A recent sonogram detected a solid mass....a follow up sonogram (5 weeks later) reported that it was a hemorrhagic cyst and was acutally shrinking (good news). However, during these sonograms, my doctor pointed out that my uterus had all kind of abnormalities (fibroid with blood in it), and many other possible diagnoses (endometriosis, abnomyosis (I think that is what it is), which are all generally benign conditions. I have NO symptoms of any of these uterine conditions and my periods are normal and not really painful at all. If my cyst does not shrink all the way (it was complex and needed to be kept an eye on), I will head into surgery to have that ONE ovary removed. My doctor is asking me to think about having my uterus removed at that time, to avoid future issues that are associated with my many abnormalities in my uterus (I keep getting different reads from various sonograms). My paternal grandmother died of endometrial cancer and my older sister just had an abnormal hyperplasia diagnosis and needed a DNC. Should I even consider removing my uterus which I acknowledge has tons of abnormalities that could prove problematic down the line, but currently feel 100% normal (no symptoms, accept for an occasional twinge and minor cramping around ovulation and first few days of period). I don't want to keep having surgeries...but I am struggling with idea of removing the uterus when I have no symptoms and my current quality of life is excellent. Any thoughts would be really appreciated. My doctor is so supportive of any decision I make, but she sees lots of abnormalities from the sonogram reports and she doesn't want me to run the risk of more surgeries than necessary! Thank you so very much!
doctor
Answered by Dr. Ramadevi Wani (3 hours later)
Brief Answer:
I would not recommend removal of uterus.

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.

What is the size of the cyst? Have you done the tumour marker CA-125? If you have not done please do it. The shrinking size of the cyst is a good sign. Repeat ultrasound after another 8 weeks to see what is happening to the cyst. This repeat ultrasound with CA-125 results will guide the further management ( surgery / conservative management). If he cyst size is more than 6cm it is unlikely to resolve and you would in all probability need surgery. The surgery would by removal of ovary by laparoscopy ( key hole surgery).
From what you have written it seems like you might be having adenomyosis or fibroids in the uterus. Both are benign conditions. Sometimes adenomyosis of uterus mimics fibroids on ultrasound. How big are fibroids? The history of cancer that you have mentioned ( paternal grand mother and sister having hyperplasia ) is not significant. so do not worry about it. You have written that your doctor saw lots of abnormalities on ultrasound. Other than fibroids/adenomyosis did she see anything else?
If fibroids are small since you do not have any other complaints, I would not recommend removal of uterus.
I hope this helps. If you have further queries, I will be happy to answer.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1459 Questions

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Suggest Treatment For Hemorrhagic Cyst And Fibroid In Uterus

Brief Answer: I would not recommend removal of uterus. Detailed Answer: Hi, Welcome to Healthcare Magic. I am Dr Ramadevi Wani. I will be answering your concerns today. What is the size of the cyst? Have you done the tumour marker CA-125? If you have not done please do it. The shrinking size of the cyst is a good sign. Repeat ultrasound after another 8 weeks to see what is happening to the cyst. This repeat ultrasound with CA-125 results will guide the further management ( surgery / conservative management). If he cyst size is more than 6cm it is unlikely to resolve and you would in all probability need surgery. The surgery would by removal of ovary by laparoscopy ( key hole surgery). From what you have written it seems like you might be having adenomyosis or fibroids in the uterus. Both are benign conditions. Sometimes adenomyosis of uterus mimics fibroids on ultrasound. How big are fibroids? The history of cancer that you have mentioned ( paternal grand mother and sister having hyperplasia ) is not significant. so do not worry about it. You have written that your doctor saw lots of abnormalities on ultrasound. Other than fibroids/adenomyosis did she see anything else? If fibroids are small since you do not have any other complaints, I would not recommend removal of uterus. I hope this helps. If you have further queries, I will be happy to answer.