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Ultrasound shows a dermoid cyst. What is the best way to treat - hysterectomy or keyhole surgery ?

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Practicing since : 2001
Answered : 11730 Questions
Hi there,
After having a smear test (which was clear) and exam in february, my doctor referred me to hospital for an ultrasound as she thought I might have fibroids. The ultrasound showed a mass (which she said was a dermoid cyst) approx 10 cm x 8cm x 6cm. I have since had two consultations with two different docs. The first one sent me for blood tests and a MRI (which I had today) and said that the cyst could be removed via either keyhole surgery or an incision about the pubic line (as with a cesarian). The second doc informed me that of the three blood tests one was normal, the CA125 level was 40 which is above what it should be - 35, and the levels of the third one (sorry can't remember name of test) were slightly raised. The other two tests I had were Alpha Foetoprotein and Carcinoembryonic. He then went on to say that I would have to have a hysterectomy! When I asked him how he had acheived this conclusion, he said he was giving the facts! I informed him that given the 'fact' I had not yet had an MRI scan he didn't have any 'facts' at his disposal and we would discuss in more detail at the next consultation when he had the results of the MRI. I will be seeking a second opinion as I was shocked at his apparent blase attiude and lack of compassion, so clearly there is no trust. If you could please advise whether a hysterectomy is normal procedure in these circumstances as to be honest it sounds very drastic. I'm 44 with no children and have a BMI of 23 so normal weight to height ratio.

Thank you for you assistance.

Best regards,

Posted Fri, 1 Jun 2012 in Vaginal and Uterus Health
Answered by Dr. Rakhi Tayal 3 hours later
Thanks for posting your query.
In case of a dermoid cyst, usually local resection of the mass is done. In case the cancer markers are increased and lymph nodes are involved, the local local clearance of the pelvis is needed.
The MRI scan of the pelvis will help in detecting the extent of lymph node involvement.
It is right now too premature to comment the extent of surgery needed in your case.
I am sorry that you experienced such a frustrating recent experience with the medical establishment. Trust me in knowing that this is an exception to the normal experience which occurs between a patient and a physician.
Hope this answers your query. I will be glad to answer the follow up queries that you have.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Rakhi Tayal.
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