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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Is Ovarian Cysts In Ultrasound Sign Of Cancer?

For the past six months I've had three trans-vaginal ultrasounds for an ovarian cysts. It started put at six cms, then went down to 2 cms and now it is 3.5 cms.
The first ultrasound was suspicious for ovarian cancer, but now they say is a simple cyst. What should I do?
Tue, 5 May 2015
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Radiologist,  's  Response
Hi,
Thanks for writing in.

If an ovarian cyst is continuously decreasing in size then malignancy is unlikely. A cyst measuring more than 3 cm requires regular monitoring. I guess that in the first ultrasound, the cyst was measuring 6 cm and had no features other than its size to suspect malignancy. It is a regular protocol to repeat ultrasound in 2 to 3 months before doing cancer specific tests.

I agree that in the second ultrasound, the cyst reduced to 2 cm which is a good response. You have not mentioned about any treatment you were taking at that time and I guess you were taking treatment and therefore there was a response. This sort of treatment response occurs when there might be any hormonal imbalances causing the cyst and correcting it leads to decrease in the cyst size.

In the third ultrasound, it is possible that the hormonal balance again got altered and therefore the cyst increased. However to put at rest any suspicion of malignancy I recommend you to get a CA 125 level test done to confirm that your cyst is not at risk or a malignancy. Please do not worry.
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Is Ovarian Cysts In Ultrasound Sign Of Cancer?

Hi, Thanks for writing in. If an ovarian cyst is continuously decreasing in size then malignancy is unlikely. A cyst measuring more than 3 cm requires regular monitoring. I guess that in the first ultrasound, the cyst was measuring 6 cm and had no features other than its size to suspect malignancy. It is a regular protocol to repeat ultrasound in 2 to 3 months before doing cancer specific tests. I agree that in the second ultrasound, the cyst reduced to 2 cm which is a good response. You have not mentioned about any treatment you were taking at that time and I guess you were taking treatment and therefore there was a response. This sort of treatment response occurs when there might be any hormonal imbalances causing the cyst and correcting it leads to decrease in the cyst size. In the third ultrasound, it is possible that the hormonal balance again got altered and therefore the cyst increased. However to put at rest any suspicion of malignancy I recommend you to get a CA 125 level test done to confirm that your cyst is not at risk or a malignancy. Please do not worry.