adnexal mass

[donna656]

Hello, I was hospitalized last week for recurrent nausea and vomiting that lead to dehydration. I had a CT scan and was told I needed to follow-up with my OB-GYN for possible cyst on my left ovary. I had a hysterectomy in 2002 for abnormal bleeding and endometriosis along with what I thought was a left salapingo-oopherectomy but apparently was a right according to this report. Today when I saw my family physican he asked what my OB-GYN was doing because he was concerned. I had not made an appointment because I had planned to follow up at my yearly appointment. Anyway to make a long story short, he gave me my CT report and this is the impression: 5.5 X 4.6 x 2.5 cm complex left adnexal mass which appears to contain multiple cystic and solid components with mild adjacent soft tissue stranding and small amount of free peritoneal fluid. This is adjacent to the sigmoid colon but does not appear to be arising from the colon. This could represent a torsed left ovary, complex left ovarian cyst, left ovarian cystic neoplasm or hydrosalpinix. Pelvic ultrasound may provide useful additional information.
Now I have began reading about torsed ovaries and ovarian cystic neoplasm and I must admit, I am very worried. My OB-GYN appointment is 2 weeks away and I will worry to death until then. Can you offer any clarification from the report findings above? I appreciate any information you can offer. By the way, initially I was told I had a virus, now I am being told I have diverticulitis.

[belinda8622]

im a 24 yr old who has suffered from cyst for 3 years now.i recently ended up in the er with sever pain to my lower pelvic and abdominal i has a sonogram done and was found a left adnexa complex mass(cystic&solid) that is 5.5x4.2x5.6cm.....should i be worried?

[Annekathryn Goodman, M.D.]

Hi there,

You just had surgery so we know that if there had been any significant abnormalities on the ovaries, your surgeon would have seen them. One thing you should do is ask for a copy of the operative note so you can read the description of the surgery and see the comments about what your ovaries looked like at the time.

It would also be good to get copies of your ultrasound reports from before surgery so you can see what the description of your ovaries were at that time.

I note that you had endometriosis on your uterus so it is quite possible that you have some on your ovaries and you could develop cysts of endometriosis on the ovaries (called endometriomas) in the future.

Unless your surgeon saw endometriomas on your ovaries at your surgery 6 weeks ago, it is unlikely that you have developed them this quickly.

so it is possible that you have:
- ovulation with some bleeding into the cyst- this will resolve
-a hematoma from surgery (some bleeding that collects as a blood cyst) which will resolve
-an infection in your ovaries causing an abscess - this is serious and needs to be treated with antibiotics. there are occasions that a person would need to have an abscess drained or the ovary removed

You should set up an appointment to see your surgeon for an evaluation. You should check your temperature and to check for fever. if you have a temperature over 101 F, you need to go to the emergency room.

If you have no fever, a follow up visit with your surgeon and a repeat ultrasound in a month would be my recommendation
best wishes

[worrydsic]

Dr. Goodman,

I am hoping you can help me.  I had a hysterectomy March 26th of this year.  It was done though an incision across my abdomen.  I was having numerous probs, such as HEAVY bleeding, pain etc.  I also had two solid masses located in my endometrim.  The bx showed Cervix: squamous metaplasia, cronic cervicitis and nabothian cyst. Endomet. weakly proliferative patterns with areas of cronic endometreosis, hemosiderin deposits and reactive stromal changes. Also Myometrium Adenomyosis.

Moving on, since my surgery I have had the continual feeling of a UTI full bladder, pressure, frequency and urgency.  I have had UA's blood work, stool samples etc... all were normal.  My employer (Internal Med) sent me for a sono.  The results are as follows - Interval 1.9 cm complex cystic left ovarian mass.  THIS DOES NOT REPRESENT A SIMPLE CYST AS IT HAS INTERNAL ECHOES/DEBRIS.

Interval 3.7 cm SOLID LEFT ADNEXAL MASS, ADJACENT TO THE LEFT OVARY.  IN VIEW OF PRIOR PELVIC MRI, COMPARATIVE INTERVAL FOLLOWUP CAN BE CONSIDERED FOR FURTHER EVALUATION, AS WELL AS COMPARATIVE SONO F/U IN TWO MONTHS TO CLARIFY LEFT ADNEXAL MASS AND THE INTERVAL COMPLEX CYSITC LEFT OVARIAN MASS.

I faxed my report to my surgeon ob/gyn and he never called me.  Is this anything to be concerned about?  I stil have symptoms yet I can't get anyone to listen to me!  

PLEASE HELP!

Thank you!

[donna656]

You are absolutely right. When I went back for the ultrasound, everything was normal, nothing was found and my ovary was fine. What a relief. I have never had issues with ovarian cyst so this was a little strange for me. I greatly appreciate you taking time to respond. Both doctors wanted to rule out cancer and for a week I was very worried. It was such a relief to get good news.
Thanks again
Donna

[Annekathryn Goodman, M.D.]

dear Donna,
With a history of endometriosis, the most likely situation might be a new cyst of endometriosis on your remaining ovary. You could also have ovulated and had bleeding into a physiologic ovarian cyst which will resolve. There are other possibilities but it is reasonable to get a followup ultrasound. Ultrasound is a better test for ovaries than a CT scan.

if the ultrasound shows a persistent ovarian cyst, it would be reasonable to take a look at the ovary by laparoscopy. Please let us know what happens
take care