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MRI showed fibroma on the ovary. Getting pelvic pain. Should I go for surgery?

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Practicing since : 1999
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A TVS last year showed a shadow next to my right ovary. A repeat showed it was still there a year later, so an MRI (w/contrast) was ordered. I was told the report said it is a fibroma on the ovary. I'm having twinges of pelvic pain on a regular basis (not bad, but there), and a small amount of occasional abnormal bleeding. My current gyn wants to do a follow-up MRI in six months. I'm not seeing that MRI is diagnostic (only biopsy is). Can they really tell if this is benign via an MRI? I don't want to have surgery if i don't need to, but I'm not sure why monitoring a tumor on my ovary that won't go away on its own is prudent. I don't want to have kids.

I'd like to know if you agree with this approach.
Posted Mon, 25 Feb 2013 in Women's Health
Answered by Dr. Timothy Raichle 13 minutes later
Hello, I would be happy to help you with your question.

First of all, given the lack of change over a year, the chance that this represents some sort of cancerous change is virtually zero. Lets say that this was found incidentally while working something else up. If there was no change over time, and there was no pain, then the best plan would be to stop looking at it.

The presence of pain changes the approach to this problem. If the pain has been there off and on for a year, then another MRI is not going to change anything - you are still left with this small mass on your ovary and pain.

If you want to address the pain AND know what this thing is, then get the surgery (laparoscopy done as an outpatient). If don't mind the pain, and the shadow is stable, then there is no need to do anything.

Finally, if they were able to see it on ultrasound, and an MRI confirms that it is likely benign, then I think following it with ultrasound would be more appropriate and way more cost effective!

I hope that this helps!
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