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Dr. Andrew Rynne

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Transvaginal ultrasound showed complex cyst. Having mild pain. Any suggestion?

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Dr. Manjunath L Ramarajapalli

OBGYN, Gynecologic Oncology

Practicing since :1984

Answered : 99 Questions

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Posted on Mon, 31 Dec 2012 in Cervical and Ovarian Cancer
Question: Hi,
I was told I had a complex cyst by transvaginal ultrasound in July (that was previously a simple cyst in April) by my regular gynecologist. I was sent to a gynecologist oncologist and had a CAT scan (abdominal and pelvic) and the report said it was a simple cyst. Then 3 weeks later on 9/27/12, I had a second opinion from a different gynecologist oncologist via another transvaginal ultrasound. I was again told it was a simple cyst. I've asked this question before on here but would just like to ask again just to get a couple opinions. I've attached several photos of the 9/27/12 ultrasound and the ultrasound report as well. To me this photo looks like the cyst has a septation in it off to the right side. If this is the case, I thought this would be called a complex cyst but I have been told now twice by two different oncologist gynecologists that it's a simple cyst (again based on the CAT scan and 3 weeks later, the ultrasound). The report does say there is adjacent fluid next to the cyst so perhaps what I'm thinking is a septation is the wall of the cyst and then the fluid next to it.
The cyst causes me mild pain but sometimes I have a week or longer where I feel no pain whatsoever.I can post more ultrasound pictures if needed as I believe there were about 60+ different images.
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Answered by Dr. Manjunath L Ramarajapalli 7 hours later
Hello,

Thanks for posting your query and the reports. I have taken a good look at them.

The radiologists and gynec-oncologists are experts and likewise opined.

It may appear to you like a complex cyst, but probably there is ovarian tissue by the side of the cyst giving this type of picture.

If you want, you can have another expert radiologist opining about the films. Alternatively, wait for few weeks and take fresh imaging films.

Do let me know if you have more concerns.

Good luck

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manjunath L Ramarajapalli 1 hour later
Hi, Thanks for your reply. They took many photos during ultrasound and my question to you is, would the radiologist be able to distinguish the difference between a septation versus something like refraction or cyst wall by looking at the images? I am assuming they look at all the images and can tell the difference between a septation versus something else....they would likely not make a mistake by calling this a simple cyst if it were complex, correct?
doctor
Answered by Dr. Manjunath L Ramarajapalli 1 hour later
Hi,

It is difficult to comment on the opinion given by other specialist. However, CAT scan and ultrasound scan findings should be correlated with clinical examination findings by a gynaec-oncologist and take proper decision.

In case of any doubt, it is better to investigate further to rule out any grave pathology.

Good luck

Above answer was peer-reviewed by : Dr. Shanthi.E
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