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Change of ovarian cyst into cancer - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: Women's Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   I have been followed for ovarian cyst for over a has looked like a simple cyst. Now the ultra sound shows, the cyst has inlarged...3.3cmx2.8cm. It now has 3 daughter cyst which all look predominently anechocic. But the is a small papillary projection at the site of the daughter cysts. I am 61 years old. It his an indication of Cancer?
Doctor :   hi
Doctor :  
User :   hello
User :   did you see my question
Doctor :  
ovarian cysts can rarely turn into cancer
Doctor :  
yes i did
User :   what about this change
Doctor :  
i will explain
User :   yes please
Doctor :  
could you read out/type the previous scan report?
Doctor :  
and also the new scan report that shows the daughter cysts?
User :   I don't have the previous scan report but I know the cyst was about 2.4cmx2cm with on a thin septation in it.
Doctor :   is the cyst painful now?
User :   This new one says.....examination of the left ovary demonstrated a 3.3 x 2.8 cystic leasion. There are now 3 daughter cysts with this cystic leasion. It is predominatelely anachocic although there is now a small papillary projection at the site of the daughter cyst maesuring on the range of 9mm.
Doctor :   most of the time the cysts are harmless, but if there is pain, or growth associated, then it shuold be looked upon
User :   Well I something have some sharp pains but nothing different than when it was discovered a year ago.
Doctor :  
and the tests should be done for the tumor markers to differentiate between cancerous growth and non-cancerous growth
User :   My CA 125 last year was 24. Just had one done yesterday....don't have the results.
Doctor :   ok
Doctor :  
wait for teh results and see
User :   What are the possiblitlies that this is malignant?
User :   Based on the ultrasound alone.
User :   I am a registered nurse.
Doctor :  
also a endovaginal ultrasound with a MRI scan will differentiate better along with the tumor markers such as CA-125, and hormone levels
User :   Please be very frank with me.
Doctor :   based on the ultrasound finding
User :   I had dndovaginal ultrasound that was the report.
Doctor :  
the internal cystic structure may be categorized as simple (just fluid filled), or complex (with areas of fluid mixed with solid material), or completely solid (with no obvious fluid). So these will be useful to diagnose the possibility
Doctor :  
if it is just a fliud filled one
Doctor :  
then it is likely that it is non-malignant
User :   yes the radiologist called is a simple cyst at first now a complex cyst.
Doctor :  
but if the cyst is complex or solid or turning into solid then the chances are that it will be malignant
Doctor :  
so now the MRI scan along with the tumor markers such as CA-125, and hormone levels should be done
User :   What about the pipillary progestion....that is what worries me the most. and the fact the I am post menopausal.
Doctor :  
CA-125 results will rise if there is malignant
User :   Rise to what level?
User :   do simple cyst turn into complex cyst?
Doctor :  
along with changes in LH, FSH, estradiol and testosterone levels will show what to expect
Doctor :  
yes a simple cyst has chances of turning into complex and solid
User :   I have not at a LH
Doctor :  
with the cancerous changes setting in
Doctor :  
you should get that done too
User :   He did not think it looked solid....mostly like a cyst....just that one small part.
Doctor :  
also if there is fluid in POD, then it should be tested by doing a colposcopy and culdocentesis
User :   No free fluid
Doctor :  
User :   So does this mean that chances are I have waited too long and this could be matastisized?
User :   My last ultra sound which was like a simple cyst was 6 months ago.
Doctor :  
in my opinion, you should wait for the CA-125 results, and also do these tests further to differentiate the cancerous and non-cancerous state of teh cyst. the tests include MRI scan, LH, FSH, estradiol and testosterone levels.
Doctor :  
if the cyst has turned onto malignant, then it will be made out with theses tests
User :   What should the level of Ca125 be for malignancy
Doctor :  
since you are post-menopausal, and there is also a growth in cyst with the papillary projection, you should do the above said tests
User :   yes?
Doctor :  
CA-125 levels should be monitored serially if suspecting a malignancy
User :   Does papillary always mean malignancy?
Doctor :   it does not always mean malignancy, but a change towrads malignancy cannot be ruled out
User :   At what point should this ovary be removed? Now?
Doctor :  
A CA-125 test result of greater than 35 U/ml is generally accepted as being elevated and a surgery should be considered
User :   Can ovarian cysts be precancerous?
Doctor :  
yes, there are cysts that can be in precancerous stage, and serial CA-125 levels will help in monitoring these cysts
Doctor :  
and take necessary action
Doctor :  
have you followed what i have said?
User :   Yes and I think you have answered all my questions.
User :   One more question...pelase
Doctor :  
Is there any thing else I can help you with?
Doctor :   yes, please proceed
User :   If I opt to have surgery....should I consider removal of ovary only or hysterectomy?
Doctor :  
only removal of ovary is sufficient, but a hystrectomy if combined is better since you are post menopausal
Doctor :  
and also only CA-125 levels are not diagnostic, these should be combined with other tests as i have mentioned before for accurate diagnosis
Doctor :   Is there any thing else you would like to ask me?
User :   FH, FSH, testosterone and what?
Doctor :   Please fill the feedback form, and comment box, and say done when done.
User :   done
User :   Thank you.
Doctor :   MRI scan, LH, FSH, estradiol and testosterone levels along with rectovaginal examination and culdocentesis to see for cancer cells in minimal fluid not picked up by the scan.
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
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