Complex Cyst Questions

[LLM41]

I was wondering if someone could help me clarify a few questions.  I am 41 years old, perimenopausal and was diagnosed with a 5 cm complex ovarian cyst on my left ovary in early August.  I had a 2nd ultrasound at the end of August that showed it was still there but had not increased in size - although my uterus was the size of a 12 wk. pregnancy (a fibroid and some endometriosis she thinks).  My CA-125 came back at 16.  I am scheduled for a 3rd ultrasound at the end of Sept. and then will discuss my options with my OB/GYN.  I am confused about some of the statistics I'm reading about complex cysts.  Do the complex cysts still fall in the 95% benign category or is it more like 80% (as I've read somewhere out there in the literature).  I trust the wonderful people on this board more than possibly unreliable sources on the internet.  Also, Is it true that some complex cysts actually do resolve on their own?  I am not in any pain and it was found when doing a pelvic ultrasound for unexplained vag. bleeding.  I have three young children and this is causing me great worry.  Any encouraging news would be helpful!

[LLM41]

Hi Chocolate!
Thanks for your reply.  I was curious as to what they are actually "waiting" for in your case? I was told by my ob/gyn that she wanted at least one full cycle (possibly two) to see if the cyst shrinks or disappears which is why she only waited 5 wks. after the last TVU to see me again.  She has already talked to me about the possibility of taking the cyst out (and the whole ovary if need be) and due to abnormal vag. bleeding - we may end up doing a partial hysterectomy.  I don't blame you for being impatient to get this over with.  Let us know how it goes!

[chocolateone]

Yes, I was given the "wait and see" approach, has a matter of fact I have been there since approx a year ago.  This point and time I am at the sepated complex cysts stage.  Its got frustrating here and there especially when my diagnosis went from ovarian cysts to possible hydrosalpinx now complex sc/pelvic mass.  Doctors can get you so confused when all you want to here is what the botton line is and what to do next to get back on board to feeling like your old self again.  My doctor was a bit on the fence with me at the beginning but I now understand his approach better than I did last Sept.  We as patients can't see the forest for the trees at the start but as long as you have confidence in you doctor and have forums such as this to let things out it helps tons.

[MarieMichele]

Yes, I've seen others here say that they were given the "wait and see" approach even with complex cysts.  Many cysts go away after two menstrual cycles (many break down after ovulation occurs) and that is what doctors hope will happen.  When they stick around longer than that, it becomes less and less likely that they are able to go away on their own.  The low CA-125 result is good news actually, especially if they think fibroids or endo could be present.  Those tend to elevate the readings to false positive.  I don't see any problems with the approach your doctor is taking.

[LLM41]

Many thanks for taking the time to give your thoughts.  I guess what I am asking is whether it is normal to take this "wait & see" action with complex cysts?  Have other women done the "wait & see?"   I have to assume that if she really thought there was something more sinister that we would be moving more quickly on this - especially after 2 TVU's.  She did not specifically say there were solid components seen but she did indicate that it was septated.  From reading other posts - it seems that I should not be necessarily reassured by a normal range CA-125 either.  (Although better normal than high, I guess!)  I did read somewhere that the CA-125 has higher rate of false POSITIVES than false NEGATIVES which would be somewhat reassuring if that was true.  I am probably reading too much and I need to stop googling stuff because it's making me crazy!  Any other opinions?

[MarieMichele]

I would ask the doctor what is known about the complex cyst and whether it shows solid elements, (i.e. not just separate chambers of fluid filled cysts).  The more solid features a cyst shows, the more worrisome they become and should be removed.  In-office exams and ultrasounds can only confirm the existence of a cyst and its general physical properties, but cannot say with any certainty what is benign (remember always that ovarian cancer is rare but it seems much more common when you visit a forum like the ovarian cancer forum because people dealing with the disease spend time there).  

I wouldn't want to trust numbers and statistics, but just the specific features of your own cyst and whatever symptoms or discomfort the cyst, fibroids/endo may be causing you.  If your quality of life is being diminished by this, surgery will do you a world of good, not to mention the reduction of stress and anxiety wondering what it is and what it is doing.