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Dr. Andrew Rynne

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Can untreated hypothyroidism cause ovarian cysts?

Answered by
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Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 13337 Questions

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Posted on Thu, 2 Aug 2018 in Women's Health
Question: Okay so we just got back from my 64 yo mother’s full health screening at the hospital and during the pelvic ultrasound, she says the doctor mentioned about a water-filled cyst/cysts (not sure) in her ovary (nothing more). The health report will come out Monday but we’re feeling extremely anxious/afraid after reading several articles on the net about this being uncommon in post-menopausal women.

My mother’s sister died 30 years ago at the age of 36 of ovarian cancer, so this really worries me. What I find weird is her pelvic ultrasound 3 years ago (on her first health checkup, this being her second) was perfectly fine and the ovary showed no lumps/cysts. At that time, I had specifically taken her for her first health checkup because she cannot control the urge of urination much and her stomach was bloating out and she would get full after eating fast (which could be symptoms), but was relieved the reports had come out clear. She's fine otherwise overall.

They haven’t done any CA-125 test yet and she refused to do mammogram/pap smear as they hurt her a lot last time and all was normal.

On her first health checkup, she was only diagnosed with moderately high cholesterol (that’s fine now) and slight hypothyroidism (for which we didn’t start levothyroxine against the doctor’s advice since she’s not disciplined enough to take that drug religiously day-to-day and missing doses is highly dangerous). She had a total LHR and both eye cataracts last year.

I don’t know where this cyst has popped up from, but I’m so low that I don’t feel like getting out of bed until Monday. Can someone please help us with this? Could untreated hypothyroidism be causing this?

We are leaving for the US to visit my father next week and my mother will be staying there for 6+ months before coming back to XXXXXXX as she has recently become a Permanent Resident, but this thing is really scary and I don't know what the reports may say on Monday.
doctor
Answered by Dr. Rakhi Tayal 1 hour later
Brief Answer:
Can be a small harmless cyst.

Detailed Answer:
Hello,
Thanks for posting your query.

There can be a small simple cyst in the ovary even in the postmenopausal age group. It is worrisome only if the cyst is larger than 5cm in diameter or is a complex cyst.

Going for CA-125 will also help in ruling out any malignancy. Untreated hypothyroidism is not likely to be related to the ovarian cyst.

You can wait for the report and as no further tests were done the cyst is likely to be a small harmless cyst. Do wait for the report and follow up with her gynecologist for any further test if needed.

I hope this answers your query.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rakhi Tayal 39 hours later
Hi Dr. XXXXXXX

Thanks for your reply. The reports came today and I'm attaching them. It says: 2.9x2.3x2.5cm cystic lesion with internal echoes and few septae in right adnexa and similar lesion 3.9x3.6x2.5cm in left adnexa, both ovaries not seen separately. No evidence of free fluid or mass in pouch of XXXXXXX I'm attaching the report.

We're referring a gyno asap but need your advice as well. Thanks so much!
doctor
Answered by Dr. Rakhi Tayal 5 hours later
Brief Answer:
MRI scan needed.

Detailed Answer:
Hello.
Thanks for writing again.
Your mother has complex cystic lesions on both the sides and no separate ovaries have been seen. Such lesions are worrisome and need further evaluation like MRI scan and Ca-125 levels to rule out a malignancy. Also, further follow up scan is recommended after 10 weeks in case MRI scan and blood test comes normal.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rakhi Tayal 3 hours later
Hi Dr. XXXXXXX

We just consulted our family gyno and she asked for a CT-scan with contrast along with the CA-125. Said we can even do the MRI if we want but it might be a bit uncomfortable for my mother. She also recommended to get the ovaries removed soon to avoid taking any chance.

What do you think?

Thanks
Neville
doctor
Answered by Dr. Rakhi Tayal 18 minutes later
Brief Answer:
Removal of ovaries will help.

Detailed Answer:
MRI scan is uncomfortable but is a more accurate way of excluding a malignancy. At her age with complex cysts, to avoid the stress of regular monitoring and cancer diagnosis, it is best to get both the ovaries removed as she is already post menpausal.
You can follow her gynecologist's advice and get the surgery done.
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rakhi Tayal 45 hours later
Hi Dr.. attaching the CT and blood reports.. most seems normal but says enlarged left ovary and no mention about right ovary cyst??
doctor
Answered by Dr. Rakhi Tayal 31 minutes later
Brief Answer:
Not worrisome.

Detailed Answer:
Hello.
I have seen all the attached reports.
The CT report is considered more accuirate than an ultrasound report. It shows only a small cyst in the left ovary. This is not worrisome. She can relax and get a repeat scan done after 6 months to see in case there is any increase in its size.
Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rakhi Tayal 1 hour later
Hi Dr. XXXXXXX . thanks for your relieving reply. Feeling a little relaxed finally after days of feeling devastated.

However, we are a little concerned as our family gyno, Dr. Jeroo Bhada said that although she feels a little positive about the reports, they're not 100% conclusive from these tests and because there's family history, they want to remove everything (uterus, cervix, ovaries I think) via laparatomy... we're pretty scared about such a major surgery, I thought only removal of ovaries was required if at all.. she said that CA-125 is normal in certain OVCAs.

We're in a state of confusion... what do you think is causing enlarged ovaries? I read online that it's the first sign of OVCA.
doctor
Answered by Dr. Rakhi Tayal 8 hours later
Brief Answer:
You can wait for few months.

Detailed Answer:
Ca-125 can be normal in some ovarian CAs but it is possible that your mother these prominent ovaries even earlier also. If the ovaries need to be removed then it is best to get uterus and cervix also removed as these are more prone to malignancies. But there is no emergency. We can wait and see if these cysts enlarge in size then plan such a major surgery. As such a cyst of size less than 5 cm in size is not an indication of immediate surgery.
Regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rakhi Tayal 3 hours later
Hi Dr.. didn’t understand this part in the first sentence: “it is possible your mother these prominent ovaries earlier also”.
doctor
Answered by Dr. Rakhi Tayal 7 hours later
Brief Answer:
These cysts may be present since last few years.

Detailed Answer:
It is possible that your mother had these prominent ovaries earlier also- which were not detected by an ultrasound scan done three years ago. This can happen in case the bowel loops are loaded at the time of ultrasound scan. CT scan is more sensitive and accurate and such simple cysts are not worrisome. I hope I have made myself clear now.
Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rakhi Tayal 2 hours later
Thanks Dr. XXXXXXX

What do you think of 4D color Doppler ultrasound to view blood flow in the cysts?

We referred another gyno and she said if that comes out good, we can be a little more confident and fly to US on Tuesday for 2 months without tension.
doctor
Answered by Dr. Rakhi Tayal 9 minutes later
Brief Answer:
It will help in ruling out any malignancy.

Detailed Answer:
4D scan blood flow in cysts is also not conclusive of a malignancy but will help in confirming that the cysts are more likely to be benign.
Your gynecologist is right in pointing out that it will help in easing off the stress.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rakhi Tayal 18 hours later
Hi Dr. XXXXXXX
I had sent my CT reports online to the National Cancer Grid at Tata Memorial Hospital and just received an expert opinion that says no evidence of obvious ovarian mass?? Please have a look at the attached report. I’m really confused now. I told them I’ll be sending the ultrasound films tomorrow once I get them from the hospital since they’re better at seeing the ovaries, but I wonder how they see no obvious mass when Breach Candy’s radiology department mentions a 3 cm cyst and the USG report mentioned internal echoes/septae??
doctor
Answered by Dr. Rakhi Tayal 4 hours later
Brief Answer:
A cyst is not same as a mass.

Detailed Answer:
In the CT scan reports only a cyst is seen and a simple cyst is not considered as a mass. A mass means a solid swelling. CT scan is always more reliable than an ultrasound report. You can get the second opinion on the ultrasound report also.
Regards.
Above answer was peer-reviewed by : Dr. Kampana
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