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Possibly ruptured "complex" cyst, possibly something else?

My OB/GYN told me two and a half years ago that I had a small ovarian cyst, less than 2cm, nothing to worry about. Well. I went to the ER this weekend in horrendous pain - CT, CBC, and two ultrasounds (external and internal) later - I was dx with a possibly ruptured complex ovarian cyst measuring a whopping 6.5 x 5.1 x 4.3 cm (with low level internal echoes).

That wasn't particularly worrying - though I did start to think about my slightly increased risk of breast cancer (had a scare for that summer 2019). Then, I also read the CT report.

Hypodense nodule in the spleen
Hypodense (>1cm) nodules in both kidneys "likely cysts"
Hypodense nodules throughout the liver - too small to characterize "likely cysts in the absence of a known primary"

That worried me. They suggested a follow up in 6 - 12 weeks, but my doctor wants me in on Thursday.

I guess I just wondered others experiences of something like this? If you found out you had cancer, what was your journey to dx? Were you lucky and found out it was "just" a cyst? Did your complex cyst resolve on its own? is there a risk of cancer if you have complex cysts?

Thanks.. I have so many questions
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15695260 tn?1549593113
Hello and welcome to the forum.  What a great answer above and hope that this was helpful to you.  How have things transpired?  Do you have any update for us with regards to your situation?
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Avatar universal
The most probable diagnoses are hemorrhagic cysts (classically characterized by reticular pattern of internal echoes) versus endometriomas (classically described as homogeneous low level internal echoes), the former which will improve/resolve but the latter which will persist after 6-12 weeks. It is unlikely that you have ovarian cancer (as the more aggressive ones typically present with septations and/or nodularity). For now, there is no need to worry. Just be sure to get the pelvic ultrasound in 6-12 weeks and follow-up with your doctor, at which time you can consider MRI pelvis if further characterization desired.

To address your other question regarding findings on prior CT, a solitary hypodense nodule in the spleen is nonspecific but probably benign (e.g., cyst or hemangioma). The findings in the liver and kidneys are also probably benign (e.g., cysts). These can be further characterized with MRI abdomen if further characterization desired.
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