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Laparoscopic surgery and complex cyst/ neoplasm

Hi,

I am 36 y.o. woman, without children.  I have a left ovarian complex cyst that has been followed for slightly over a year now.  (I have had 4 ultrasounds and 2 MRI's).  My GYN doctor has been suggesting a laparoscopic surgery which I have been trying to avoid, till now.

Healthwise, I am pretty "normal" I would say.  Average weight, average health. On the down side, I have some level of pain during my period (sometimes high, sometimes mild), occasional pain in my lower left and/or right abdomen, I am occasionally bloated and tend to have a talkative tummy, I occasionally have frequency and/or urgent need to urinate, and I often feel a little tired (but not overly fatigued).  Those are my down, but overall I feel "relatively" fine and healthy.

My complex cyst seems to be varying very slightly between exams (average and latest size: 3.8 x 2.7 x 3.8).

It seems to be described ever so slightly differently at each exam.
In chronological order here are the findings:  

-complex cyst with thick fluid and several solid areas within/ (also small amount of free fluid in right adnexa)
-cystic mass with irregular border and soft tissue complement/ (the myometrium is heterogenious raising the question of diffuse adenomyomatosis/ ovarian cystic mass most likely represent endometriomas)
-hemorragic cyst/ (most likely physiologic/small amount of free fluid in cul de sac and adjacent to right ovary)
-hypoechoic lesion with internal debris and thin avasular septation/ (atypical endometriomas?)
-oval left sided cystic lesion/
-complex cystic lesion with enhancing nodular component suspicious of ovarian neoplasm (latest MRI)

I have no or very little history of cancer in my family (my grandfather was diagnosized with colon cancer in his 80's), no one else that I know of has had cancer.

I had some blood tests done mostly normal, ever so above normal CA-125 @ 24 (very low for a high it seems)

My first question is:

What is the likelyhood that it may be cancer?

And my second question is:

I finally agreed that I indeed need the laparoscopic surgery and during my pre-op appointment my GYN (who is not an Oncologist) asked me if I want an Oncologist present during the operation or if I would prefer that he stops the operation if the "lesion" appears malignant and deal with it after the laparoscopy.  He wanted an immediate answer, but I felt I needed a day or two to think about it.

From my research, if it is malignant, it will require a quick response and a very skilled GYN/Oncologist.  If I am not sure, during my laparoscopy, of who the GYN/Oncologist would be, and how skilled they may be, am I better off not having one at that time and dealing with it after the laparoscopy? Or should I have one regardless of whether I will know who he or she would be?...

Thank you very much for reading and for your feedback.  I really appreciate.

2 Responses
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408163 tn?1242949501
Hi There,
I agree with Trudie. I too did the watching and waiting game for over a year. I had several opinions and all said the masses had to be removed. I had a gyn/onc do my surgery and all the "mess" came back benign. Thank God. Surgery is stresstul enough, without having to think you might need more than one. You only get one chance to do this right, so have a gyn/onc on standby and get it all done at once. Good luck and let us know how you are making out...
Laney
Helpful - 0
483733 tn?1326798446
I am so glad you are having the surgery.  This needs to be addressed.  You want to have the gyn/onc present at your surgery.  It is much more likely to be successful and easier on you if you have only the one surgery.  Over 95% of all cysts are benign.  Good luck and please let us know how it goes.
Helpful - 0
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