ovarian dermoid

[Gigi1111]

Hi,

I am 32 years old have a four year old and a 19 month old. When I was pregnant with my 19 month old they found on an ultrasound a 2.3 cm dermoid cyst. My OB/GYN told me not to worry but to do a follow up in 6 months to see if it has grown. The Dr. recommends we don't remove it unless it is bigger than 3cmm so that way she won't need to remove the ovary.

I am going to be doing an ultrasound next month. I know that there is a small chance that it can be malignant, my family doctor strongly suggests I get it removed. Should I get a second opinion from another OBGYN? as one is telling me not to worry and the other is concerned.

Help!! Im also scared that it is cancer.

[Gigi1111]

Thank-you for all the information, which I find very helpful. I have a follow up appointment coming up in November and will request the tests that you've have noted above. I live in Canada so there is a bit of a longer wait for scans and MRI's. But you have been very helpful and put me more at ease. Once again thank-you.


I hope that your wife is doing well.

Will keep you posted

[kcd86]

I am sorry you have to go threw this it is very stressfull to have this hanging over your head. Keep in mind most dermoid cysts are benign!! Since your transvaginal sonogram(TV) showed a dermoid cyst (also known as Germ cell tumors) on your ovary warrants a very thourough work up to rule out any other potential issues. The most common ovarian germ cell tumor is the benign mature cystic teratoma (dermoid cyst).
My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 and I know what it feels like to not know what the next step is. Here is a quick overview.
Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx). A transvaginal ultrasound (TV) is the most valuable diagnostic study in the evaluation of an adnexal or pelvic mass/suspicious cysts.  Cysts, hemorrhagic cysts, endometriomas, and dermoids have a high predictive diagnosis via TV ultrasound.
An MRI is usually the next test that should be given as they are more precise when read by the right radiologist.
The blood test CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other causes of inflamation..
There are other types of ovarian cancer that are associated with hormonal or enzymatic activity and depending which form a person has there will be excess symptoms of that specific hormone. Germ cell ovarian tumors fall into this catagory. You should have your blood drawn for the following, Inhibin A&B, HCG, AFP,LDH, CA-125 and CEA.
Unfortunately with any type of suspected ovarian mass/tumor/ suspicious cyst(s) surgery will be the only way for the Dr's too make a definitive Dx.
It is NOT recommended to biopsy any ovarian mass/tumor/suspicious cyst as it can rupture and seed the pelvis with cancer cells if that what it turns out to be.  
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Since there is some suspicion based on your TV-sonogram I would immediately find a good GYN/Oncologist surgeon. I am not suggesting what you have is cancer but studies have shown that treatment of ovarian cancer by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management. This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal.
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Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best.
Kevin
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