Fluid leakage from an ovary during surgery

[Gina3754]

I recently had vaginal surgery for uterine prolapse.  The doctor was also going to remove my left ovary because of a cyst found on the ovary.  The doctor discovered I had cancer (papillary serous borderline) in both ovaries.  No oncologist was available during surgery, so she removed the uterus, fallopian tubes, both ovaries and cervix. Note: when the doctor grasped the ovaries, a yellowish fluid leaked out of them while they were still in my abdomen. I am concerned that there were cancer cells in the fluid. I now am seeing a gyn-oncologist and have to have staging surgery.  My healing was delayed because of an infection in my sutures.  Has anyone ever had this situation happen to them?  

[Gina3754]

I found this on the internet:

As far as physical manipulation of the cancer, there has been a longstanding perception among surgeons that inadvertently squeezing an early cancer may cause cancer cells to break off into the blood stream and/or the lymphatic system and spread. Most of the research has been done in colo-rectal and pancreatic cancer surgery and there does appear to be some effect. From that, various "no-touch" techniques have been developed for various procedures. There is no medical evidence that this is true in ovarian cancer surgery, but minimizing manipulation is considered prudent by many surgeons.

[Gina3754]

I have heard that many young women keep their other ovary (as long as it is disease free) so you don't go into a medically induced menopause (you are way too young for menopause).  Hopefully, your gyn-oncologist consultant knows what he is doing.  My gynocologist did not.  

[Heffmeister]

Thanks for you response Kevin, interesting to me as well. I hope they staged me properly then. I had a lots of "wash outs" and numerous biopsies all which were negative- I presume my other ovary looked normal otherwise they would have told me already. I had a laprotomy done and have a massive almost 4" vertical scar to show for it :-(

Been a bit scared reading above about 5-10 year survival rate as I am only 32 with 2 children who are only 2 and 4 years old! If the cancer cells were in the abdomen what sort of cancer could this possibly cause in years to come? I too can't find out much info of the web.

I need to decide now to whether to precede to a hysterectomy and removal of my other ovary. My situation is made worse by having previously had high grade abnormal cells removed from my cervix twice.

[Gina3754]

Thank you both for your responses.  It has been so difficult to find any information on this ovarian leakage on the web or even from my ob-gyn.  I am under the care of a gyn-oncologist who is highly recommended and he is scheduling a open abdominal staging surgery on me in two weeks.  I was hoping for lapascopic surgery, but now I see from kcd86's email that this is probably the way to go (be aggressive).  I hope to live at least another 20 years to see my granddaughters grow up (their paternal grandmother died a few years ago and I am the only grandma they have).   My original surgery was via the vagina and the oncologist says this was not the way to do it (the cancer was found by accident).  He says that the ob-gyn should have investigated the cyst on my ovary (she was aware of it) before doing any type of surgery.  Oncologists have the mindset that a cyst is always cancerous until proven otherwise.  Heffmeister, you probably had the staging surgery during the original surgery.  This is where they remove the lymph nodes and fat layer in the abdomen,  Thanks to you both again.

[kcd86]

The majority of borderline tumors are serous. A large percentage of patients are diagnosed with stage I disease. Aprox 25 to 50 percent of tumors can be bilateral. These tumors tend to remain confined to the ovary. A complete surgical staging is important for both diagnoses and specific treatment purposes as 25 to 30 percent of women with serous tumors will have extraovarian disease.  In some literature staging is questionable as some Dr's say tumor is slow growong and 5-10 yrs survival rate is very high. Yes these tumors are reported to be slow growing, this does not mean take your guard down especially since you reported that the fluid has leaked from the capsule of the ovary> I would be aggresive and find a good GYN/Oncology surgeon with a lot of experience with these type of issues. Be aggressive stay on top of your physicians , be your own advocate and retain copies of all tests/results. Post with any other questions you may have as this site has some very knowlegable people on it.
Good Luck
Kevin

[Heffmeister]

I wouldn't worry to much. From what I've read these "borderline" tumor can occasionally spread but they would be very slow growing. Your staging surgery should remove anything I imagine. No one has mentioned "staging" me but maybe they did it with the original surgery? I haven't seen an oncologist yet either although my (gyny) consultant specialises in oncology. Think it's a bit different here- I'm in the UK.

Good luck with the surgery.

[Gina3754]

No, I was not washed out and my surgery was 4 weeks ago.  I have been to an oncologist, but he has been unable to do the staging surgery (to remove my lymphs and fat layer) because I developed an infection in my stitches.  I sure hope nothing was spread.  He did schedule my surgery in two weeks.  Hope everything goes well with you.

[Heffmeister]

Hi, I've just been told I had a borderline ovarian cyst/mass as well. Mine was a mucinous cyst and had burst before my surgery. The cyst was melon sized and I had 2 litres of fluid/pus draining out of my abdomen as well which presumable contained the nasty cells. I've yet to know what the consequence of this is as I'm seeing my consultant next week. He did say on the phone that I was throughly washed out and the fluid sent for analysis plus loads of biopsies taken internally. Do you know if this was done with you? I imagine the onocolgist will help you and advise of what follow up checks you need.