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Have ovarian cyst. Family history of ovarian cancer. Elevated ca 125 blood test. Hysterectomy needed?

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OBGYN, Gynecologic Oncology
Practicing since : 1984
Answered : 99 Questions
Had OB doctor say that I shouldnt need to bleed somewhat heavy during periods, I didn't think it was a big deal. She said you need to keep your blood. She did ultrasound, vaginal one as well. Found fibroid, cyst on ovary and polyps. Said I can choose to have hysterectomy, one ovary removed, all removed, or do D&C and ablation and monitor Cyst for 6 months.

I chose to do D&C and ablation on 2/13/13. 3/1 Ultrasound done again to review after surgery.
Golf ball size cyst on ovary is now somewhat larger since found on first ultrasound on 1/18 and so I need to pick from options again. All out - uterus, ovaries, etc. or just one ovary or some combo of items.

Did CA125 blood test on 1/21/13 and it was elevated, about 44. Have history of ovarian cancer, maternal grandmother. Mom and aunt all removed, hysterectomy, ovaries, etc.

When my 2/13 Surgery was done, she said I had more polyps in my uterus than she has ever seen in thousands of cases.

My follow up ultrasound post surgery shows irregular cyst on ovary a big bigger and now I need to choose surgery options again.

What would your advice be??

Posted Fri, 5 Apr 2013 in Head Injuries
Answered by Dr. Manjunath L Ramarajapalli 10 hours later

Thanks for the query.

I went through your detailed history with diligence.

It would be better to opt for hysterectomy with removal of ovarian cyst and perform a frozen section examination of removed sample.

In the presence of some family history of ovarian cancer this seems to be the right option.

Let me know if you have other enquiries.

Good luck.
Above answer was peer-reviewed by
Follow-up: Have ovarian cyst. Family history of ovarian cancer. Elevated ca 125 blood test. Hysterectomy needed? 12 hours later
They want me to remove both ovaries, the one with the cyst and the other because of bi-lateral potential occurrence of cancer on the other ovary being about 50% liklihood, if it is cancer.

You would not remove ovaries, just cyst and test first?
Answered by Dr. Manjunath L Ramarajapalli 11 hours later
Decision to remove one or both ovaries depends on the frozen section report of the ovarian cyst during surgery.
If the report comes as benign ovarian cyst, then you can keep the normal looking other ovary.
If the report is malignant as a part of staging procedure, the other ovary is also removed.
Therefore, it is test first, frozen section examination of the ovarian cyst, which will decide how to proceed further.
Good luck
Above answer was peer-reviewed by
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