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What Does "thick Septation Is Present In Inferior Portion Of The Cyst" Mean?

Posted on Sat, 7 Jun 2014

Question: I have had CFIDS/ME for almost nineteen years, the symptoms are controlled my medication, so most of my symptoms I assume are from the CFIDS; such as weight gain, fatigue, inability to focus, on and on. Lately, I have noticed that my stomach is really big, I feel bloated all the time, some pain in my lower abdomen. I had a hysterectomy in 1985, so I know it isn't my uterus. I went to my Dr. and she ordered an ultra sound. It shows a large cyst, about 9x10". The report says that it is most likely an Ovarian Cyst, and I have a CT Scan scheduled in two weeks. I can't feel this Cyst, and am wondering if it possible Ovarian Cancer since it is so large. Should I be concerned about this? If it is that big, could it just be a benign cyst? There is another small cyst on my kidney (all is on left side), but it doesn't seem to be a concern. The report describes the cyst as "complicated". What does that mean? It also refers to "a thick septation is present in the inferior portion of the cyst". It also refers to the smaller "renal cyst" which I assumed meant it was on my kidney. there is more, but this is most of what I don't understand. Would you please explain this to me? Thanks.
XXXX

Answered by Dr. Indu Kumar (33 minutes later)

Brief Answer:
You have complex ovarian cyst.

Detailed Answer:
Hello XXXX
Thanks for writing to HCM

I have gone through your findings in detail.
You are suffering from large complex ovarian cyst.Its complex nature is suggested by thick septations in the inferior pole of the cyst.
In most of the cases ovarian cysts are difficult to locate by self palpation.

Large size of the cyst doesn't indicate its cancerous nature.
You are rightly advised for further investigations.
You need Contrast CT Scan of abdomen along with clinical correlation and tumour markers.
Treatment of complex ovarian cysts depend upon many things like age,symptoms etc.

Since,it is symptomatic in your case,you may be advised for surgical removal.
Histopathology can exactly tell true nature of tumour means it is benign or malignant.

You shouldn't worry about septations,it may develop due to infection in cyst.

From USG findings,it appears that you don't have malignant tumour.Malignant tumour has many other components like nodularity,solid areas etc.
Exact nature of cyst can be definitely ascertained by further investigations only ,so you should go for it.

Small cyst in left kidney is most likely due to age related changes.It is not a matter of concern and it doesn't require any treatment.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Indu Kumar (13 hours later)

Thank you for your help. A few more questions, please; what exactly is a septation? Does this refer to something being septic? I am not aware of any infection; would I have symptoms from an infection? What does the "inferior pole" mean? Is this the smaller side of the cyst? What is USG? Since I am going on 68, I don't want to have any surgeries other than the procedure to help get rid of my incontinence problem. Can a large cyst like this be shrunken by any means such as medicines, diet, or radiation, to make it small enough to avoid another surgery? What is Histopathology? I think I remember that they don't do radiation to the abdomen; is that right? What about radiation in pill form?
If this was a cancer, I would not have surgery or chemo; I am too old, and would rather have a shorter time without all of that than a longer time with all of the
recuperation from surgery, pain, chemo side effects, etc. Just my own personal preference. Please advise. I appreciate your help in understanding these things. The Doctors here are always so busy...

Answered by Dr. Indu Kumar (9 hours later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX
Thanks for writing to HCM

Septations are not related to septic.These are thin fibrous bands inside the cyst lead to formation of compartment inside the cyst.It may be formed if there is some infection inside the cyst,patient's are not aware of infection.

Inferior pole means lower side.
USG is Ultrasonography.

Treatment plan depend upon investigation findings.
Large cyst usually require surgical removal.
Histopathology is tissue examination after surgical removal of organs.
Radiation therapy is need in some cancers.

You don't worry.Most likely you have benign cyst and let it confirm by investigations.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

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