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How to determine whether a hyperechoic mass in ovary is benign or malignant?

Answered by
Dr. Rakhi Tayal


Practicing since :2001

Answered : 13535 Questions

Posted on Wed, 21 Oct 2015 in Women's Health
Question: I had a catscan last month on the torso which showed an adnexal cystic mass on the left ovary; ovary
seemed rather large. Called "hyperechoic mass", and tech noted "neoplasm??". An ultrasound on the
pelvis; ovaries, uterus, cervix also found this in detail later. What are the best diagnostic tests to take to ascertain whether the mass is benign or may have abnormal cells, etc? And are tests invasive, or just the blood analysis, or what? I am 87; good lipod, ,etc. tests; good stress test results (though I had an acute cardiac symptom incident and went in hospital for that w/" No diagnosis." I know nothing about the ovary problems and would appreciate your expert opinion about "what's next?"
Answered by Dr. Rakhi Tayal 17 minutes later
Brief Answer:
CA- 125 levels and biopsy.

Detailed Answer:
Thanks for trusting us with your health concern.
To find out the nature of the ovarian cyst that you have it is best get your CA-125 levels evaluated. It is ovarian cancer marker and a blood test will help in evaluating the levels. Raised levels are suggestive of cancerous cyst.
To know for sure, biopsy is the only way. It needs at least a laparoscopic procedure for removal and biopsy. This is an invasive procedure.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL

Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Rakhi Tayal 20 hours later
My husband, age 81 yrs. is a diabetic. For months, he has woken at XXXXXXX because of acute feelings of hunger, weakness, and discomfort. He arises, makes a cereal, etc, eats and returns to bed. He is diligent in checking his blood daily, several times and averages 5 I.U. insulin (70-30) which stabilizes him. In these XXXXXXX events, he tests his blood sugar, which is within normal limits...we have no idea why this happens. He finishes eating about 10 p.m, with a dessert on the previous evenings.
Are his nutrient distribution organs failing in some way? He has also had a cancer diagnosis last year,
with resulting therapies (prostate type with metastases to thoracic spine) and is in remission, and being checked periodically.
Please advise...he can't be the only diabetic in the world with this condition. We need an answer.
Answered by Dr. Rakhi Tayal 3 hours later
Brief Answer:
Can be a normal variation.

Detailed Answer:
Thanks for writing again.
In diabetes the feeling of hunger in the early morning hours is a normal variation. It depends on his biological clock. If the blood sugar levels are within normal limits there is no need to worry. It is not suggestive of any failing organ.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Rakhi Tayal 26 hours later
I had an exam today by a gynecological oncologist, here in Oregon. She did a pelvic and did not find a hard lump, rather more of a cystic mass, as described on the ultrascan of a week ago. She ordered a blood test panel of 7, including CA-125. Her hospital lab showed my level at 225; she said, much too high, and recommended that I go through the laparoscopy procedure to remove the left ovary which is affected. The right ovary is clear of pathology. This within the next 2-3 weeks on the surgery schedule. I suppose I have no questions for you but thought you could give insight into your experiences with patients needing this procedure. I am presuming heart and lung exams , xrays which were ordered also, have shown I can take this op, at the age of 87. I am in pretty good health otherwise. What is the usual anaesthesia method, I wonder? And how long and eventful is the convalescence, walking about and so forth. I have no home help, and would need to see to that. [The surgical staff is highly regarded; and the medical center here wins "prizes" for successful procedures, etc]. Even though I am aged, she and I both feel it would be folly to refuse to have the ovary removed.
I suggested the abnormal cells might come from any location in my body?; she discounted that. I have no way of knowing of course, I was just making a wild guess. Do you have some comments and suggestions for me? This is all new to me, never having had a serious operation such as this in my life. Will look forward to hearing from you. I realize this is only a long-distance outline of my situation but it's all I have.
Answered by Dr. Rakhi Tayal 9 hours later
Brief Answer:
Recovery may take upto 2 weeks.

Detailed Answer:
For the laparoscopic removal of ovary, a general anaesthesia is needed. The recovery usually takes 2 weeks. You can start walking after 2-3 days. You may feel a weakness for sometime after that.
It is best for you to get the ovary removed. Since there is an abnormal mass in the ovary the raised Ca 125 levels re due to ovarian problem. Local lymph nodes also need to be evaluated. After the histopathology report comes you will be able to know the type of cells you had.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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