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Dr. Andrew Rynne

Family Physician

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Transvaginal ultrasound showed complex cyst and fluid next to it. Any solution?

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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Posted on Wed, 2 Jan 2013 in X-ray, Lab tests and Scans
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'd like to also know if a radiologist would be able to conclude from the 60 plus images of the cyst on ultrasound if he was viewing refractions versus real septation versus just a part of the cyst wall (this is for the area I keep thinking looks complex)? I assume the radiologist would not call the cyst "simple cyst" if he saw this right side area line as a septation, but would rather call it "complex"?
If more photos needed, let me know.
doctor
Answered by Dr. Ganesh Sanap 49 minutes later
Hi,
We had discussed the same things in our previous query.

The right side area line is due to surrounding free fluid only. It is not septa at all. That is why measurement of cyst was taken from the same line not from the extreme one.

In addition, the outer most wall on right side does not look like a cyst wall, because it is an omentum which has such a irregular texture.

I am sure that it is simple cyst. Still you want to upload 60 images; we can review. Just once, contact to customer support for the same. You may mail us at YYYY@YYYY

Thanking you.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ganesh Sanap 1 hour later
Thank you. I definitely won't load 60 images. I was thinking only some additional ones but I think I feel better with the answers I've received on here.

The only last question is what you mentioned about the omentum "which has such a irregular texture"....is this omentum normal/typical of how fluid would appear adjacent to a cyst? Or did you mean this is the actual omentum - the large fatty structure located in the body?

Thanks and this should be my last question.
doctor
Answered by Dr. Ganesh Sanap 1 hour later
Hello,

Welcome back again.

Ovaries are structures located in pelvic (cul-de-sac) region , which has a structure known as cul-de-sac which is like basket so any fluid will collect there in first instance.

Secondly Omentum is freely moving structure along bowel loops so it can move like a silk cloth in body, and it is completely normal. In images we are seeing, there is only a minor portion of the same.

Hope you have got your answer. If you are satisfied with my response please post a review.

Thanking you.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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