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How Can An Ovarian Cyst Be Treated?

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Posted on Wed, 28 Dec 2016
Question: hello
about 5 months ago I developed a dry oough.. I am 43 yr female nonsmoker. I saw a pulmonologist at a major university center who refused to send me for a ct of the chest at 2 appts. Cough waxed and waned and just this early Nov I saw a new pulm. immediatelyhe sent for a ct. It revealed bilateral mediastinal ly.phadenopathy with some small r to 5 mm pulmonary nodules and a radiologist suvgestion of sarcoid. This was followed by a PET scan where all these nodes lit up along with the left ovary. The report stated left ovary lhad active fdg intake XXXXXXX suv 8.3. bug could not visualize the ovary due to poor quality of the ct and recommended fu with gyn and a TV ultrasound.
last week.I saw the thoracic surgeon he felt either sarc or ly.Promax. and did not seem particularly concorned about the ovary hot spot. Had a mediastinoscopy last Friday and I have been diagnosed with sarcoid old lymphoma and cancer ruled out.

in the interi. last week I saw a gyn onc. She did an exam and explained she was concerned what results of my mediastinal all biopsy would be in determining our next step. I had a TV us done tgat day. The report was noreally endo.etrial lining of 7.6 mm , listed measurements of ovaries and said normal study. I should also note I am on the bcp and have e been for probably 20 plus
years on and off next er been pregnant, no cbildren. the pet sca.n was donever on the end week of bcp pills on a regular week packet. the tv ultrasound a week later.
I had a ct wo contrast of abdomen and pelvis I Oct 2016 in the er for pain in the lower right side. The only thing the ct noted was fluid in the cul de sac perhaps from a ruptured ovarian cyst or inflammation but I am not sexual ly active for 3 years now. I also see my gyn every year for pap.hpv and exam always normal. In oct I saw my gyn after the er visit asking if I should have an ultrasound. she stated at that time it was not needed bc the ct showed no masses and I have e been omer bc a long time so my risk of ovarian cancer e is low
I had some companies stipatio. issues over the Summerecipient but bowEl movements are normal.
never have had. a colonoscopy. no bleeding in bowel movements. nothing like that.
So I do have a past hx of left ovarian cysts from 2014 thru sept 2015 I prob had 7 tv ultrasounds ut the cysts all went away on their own and the gyn nevery felt it necessary to surgically biopsy or remove.
The gyn onc presently does not want to do the bloodtest that checks for possible ovarian cancer as she states it is not very reliable. it is better suited to monitor those with kids own ovarian cancer
so I see the dr tomorrow. My hunch is she is going to watch and wit as she stated if my biopsy comes back as sarcold she is not as worried about this sole hot spot suv 8.3 left ovary.
My brother is an er criticall care md and feels I should ask for a other ct with contrast to be done since the one from oct is working contrast. personally I am emotionally drained and scared and just want it biopsiedone and removed. my brother also.said said he does not believe sarcold. affects ovaries but perhaps consult with sarcoid specialist? The idea if watchful wacting worries me. I know none of these tests show any spread of anything anywhere else but I are dmd worried. I also know pet scans have false positive but considering I am not ovulating sin e on the pill nor no cysts are seen I would Der if that rules that out?
Thank you for any suggestions
doctor
Answered by Dr. Dr. Rakhi Tayal (58 minutes later)
Brief Answer:
Repeat Ct with contrast will help.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
A sole hot spot on the ovary is not worrisome if it is non progressive. It needs a follow up CT scan with contrast is needed to see if there is any progress. A biopsy will definitely rule out a malignancy and will remove the lesion but is an invasive method. It is best to go with non invasive investigations first like CT contrast after 2-4 weeks. Going for a blood test can help in removing the anxiety till then.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
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. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rakhi Tayal (49 minutes later)
Thank you Dr. your answer makes.sense. I guess I would like to clarify would it be wise to ask for a ct with contrast now since the ct done this Oct was done wo cotrast? and sono from last week showed no masses , perhaps missed something? Is it possible a ct without contrast did not visualize the ovaries well enough in oct?
Could I.have ct with contrast of abdomen pelvis now and then again in four weeks?
Could the hot spot on the pet scan really not be the ovary. the report says it correlates with poorly visualized ovary on the ct done with the pet scan. would it be wise to get a colonoscopy? Could that hot spot be in relation to the colon instead of ovary or would have the colon lit up? I.am not having any bleeding with bowel.move mental or strange changes in bowel patterns.
thank you
doctor
Answered by Dr. Dr. Rakhi Tayal (57 minutes later)
Brief Answer:
CT with contrast will help in finding about the hot spot.

Detailed Answer:
Hello.
Thanks for writing again.
Ultrasound scan can miss a small mass or ovaries but not a CT scan. You can ask for a CT with contrast now and repeat it after 6-8 weeks if needed.
The hot spot is more likely to be an ovary. Colonoscopy is not needed now. It can be planned after CT if needed.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

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

OBGYN

Practicing since :2001

Answered : 14041 Questions

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How Can An Ovarian Cyst Be Treated?

Brief Answer: Repeat Ct with contrast will help. Detailed Answer: Hello, Thanks for trusting us with your health concern. A sole hot spot on the ovary is not worrisome if it is non progressive. It needs a follow up CT scan with contrast is needed to see if there is any progress. A biopsy will definitely rule out a malignancy and will remove the lesion but is an invasive method. It is best to go with non invasive investigations first like CT contrast after 2-4 weeks. Going for a blood test can help in removing the anxiety till then. Please feel free to discuss further. I will be glad to answer the follow up queries that you have. 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