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Severe abdominal and back pain. Having complex septate ovarian cyst. Should I go for surgery?

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Practicing since : 2004
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Hello I went to ER with severe (not relieved with Morphine) abdominal and back pain. they found a 2.6CM complex septated cyst with moderate free fluid. They told me that its a sectioned mass and a portion ruptured causing the free fluid. I have a history of ruptured ectopic (over 10 years ago) on this ovary and the ovary has grown into the abdominal wall. I am 41 years old and in active (wild hormone) peri menopause, also diagnosed with vascular calcification and severe osteopenia with normal blood calcium but low vitamin D. Everything i have read says this type of cyst is high risk for cancer and my primary advised i see a surgeon. I'm still in a great deal of pain and concerned about my risks. Is surgery the smartest treatment to minimize cancer risk and if so is it better to have an oncology surgeon or is my obgyn sufficient. I'm worried if the ovary needs to be removed that it has grown in my abdomen, last surgery for cyst on the left side Doctor said the right ovary removal is risky because of that. I have appt tomorrow with obgyn and need some advise on what to do and the right questions to ask. Thank you
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Posted Sun, 10 Nov 2013 in Cancer
Answered by Dr. Indranil Ghosh 10 hours later
Brief Answer:
Surgery seems appropriate

Detailed Answer:
Thanks for your query.
A complex septate ovarian cyst in your age group is to be seen with suspicion (though the size is small). Serum CA 125 may be done, if it is high then probability of cancer is high. But if normal, it does not rule out cancer.
Hence, surgery is often recommended. Even if it has grown into the abdomen, surgery should not be a problem. We always prefer these things to be operated by gynecologic oncologist as you never know what you will encounter after opening the abdomen. Gynec oncs are more apt to tackle difficult scenarios.

Hope I have answered your query. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by
Follow-up: Severe abdominal and back pain. Having complex septate ovarian cyst. Should I go for surgery? 10 hours later
Thank you. The final report came back saying 2,5x2.2 cm complex cyst within the right ovary with septations and multiple low level echoes . This could be a complex hemorrhagic cyst. Moderate free fluid is seen adjacent to the uterus.

Does the possibility of hemorrhagic reduce cancer risk or is there no change to my risk?

My ob says to wait 6 weeks my primary send me to oncology ob.. I'm a little confused but it sounds like I should follow oncology ob advise since they are more experiences but just want to know if the hemor changes anything.
Answered by Dr. Indranil Ghosh 7 hours later
Brief Answer:
Hemorrhage slightly reduces the risk

Detailed Answer:
However, it is better you talk to the gyne onc before taking the final decision.
Above answer was peer-reviewed by
Follow-up: Severe abdominal and back pain. Having complex septate ovarian cyst. Should I go for surgery? 8 minutes later
Thank you
Answered by Dr. Indranil Ghosh 2 hours later
Brief Answer:
You are welcome

Detailed Answer:
If you do not need any further clarifications, then please close the query and give feedback
Above answer was peer-reviewed by
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