Is surgery necessary?

[dorigen]

I'm 27 years old and have had two episodes of appendicitis like pain in the past six months.  My ultrasound a few weeks ago showed 3 complex cysts on my right ovary.  The total size of the ovary and cysts was 8x8x5.  The largest cyst was 5cm and all showed some solid mass.  There was also a small cyst on the left ovary showing solid mass as well.  My ca-125 level was tested and was high at 852.

I am in great health and feel fine besides these episodes of acute pain and very painful periods which i've had my whole life and have seemed to get worse as i've gotten older.

My regular gyno was very worried and referred me to a gyn-onc.  I have seen two and they both felt it was more likely i had endo and the ca 125 was a false positive.

Doc A physically examined me and scheduled surgery.  He said if he saw endo he'd leave the cysts and treat with lupron.

Doc B did not physically examine me and said he would remove the cysts no matter what and most likely the ovary.  He suspected my pain episodes were from torsion.  He said he would try to go laparoscopically but the size of the cyst/ovary mass might make it impossible to remove through the laparoscope.

My question is whether or not surgery is even necessary at this point (the gyn oncs didn't seem worried at all and said surgery was not urgent, but scheduled anyways)?

And if it is, which approach makes more sense?  Leave the ovary and treat with Lupron or go for cyst/ovary removal?

Both surgeries are scheduled within the next few weeks and this is becoming a very hard decision and i'm wondering if it's worth getting a third opinion...

Thank you very much in advance!

[dreamfish]

Thanks for updating us to your situation.

I am pleased to hear of your successful outcome and am relieved to hear that its not so fearful.  There are many of us out here with similar worries and your post gives a lot of reassurance to me, and I am sure, many others.
Best wishes with your healing and continued good health from a cold and wet UK.
A

[dorigen]

Just wanted to post an update:

I had my surgery on March 26th.  Everything went well and there was no cancer despite my ca-125 level being 850.  False positives do occur such as in my case, so don't lose hope!

My complex cysts turned out to be endometriomas or "chocolate cysts" with solidified material within them and they found a fibroid they didn't know about.  Most of my right ovary was removed with the mass but they were able to salvage some of it.

I have 4 tiny incisions, only one of which is slightly painful.  Recovery has been a breeze for me so far (knock on wood), and I am shocked as to how little pain i'm actually having.  I've been up moving around and working on my computer since day 1 and eating normally.  Just waiting on that first bowel movement post surgery!

I know everyone's experience is different, but hopefully my post will give hope to others.

Best,
Autumn

[dorigen]

Here are the exact ultrasound findings if they would be helpful.  Thank you!

Remainder of examination is quite complex. The right ovary measures 8.0x8.1x5.3cm with nominal ovarian tissue observed along the medial edge of two complex cysts, one of with measures 2.7x2.8x2.0cm. A complex cyst with multiple septation is also observed measuring 5.2x4.0x4.4cm. A third right adnexal complex mass is identified at 1.7x2.1x1.6cm. These masses are primarily solid, one of which contains calcification along the rim and several have debris that is layered in appearance. The left ovary measures 4.2x4.4x3.3cm and contains a central, homogenously solid mass measuring 3.1x2.8x2.1cm. There is no free fluid in the cul-de-sac. Endometrial stripe which is measure transvaginally at 1.0cm.