WOMENS-HEALTH Messages for January, 2002: Re: 4cm Neoplasm questions

Re: 4cm Neoplasm questions

From: William McIntosh, MD (anonymous@obgyn.net)
Tue, 29 Jan 2002 15:29:16 -0600 (CST)

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In reply to: Sara: "4cm Neoplasm questions"

At Tue, 29 Jan 2002, Sara wrote: >
>I am 38 yrs. old and have always suffered w/severe cramping and heavy
>flow at menstruation (including clotting) and have recently (past 6
>months) been diagnosed w/an ovarian cyst (neoplasm w/benign
>characteristics) and a single small fibroid in the uterus.
>
>The doctors have been watching the cyst for the past 6 mos. or so during
>different times in my cycle and the cyst has increased in size very
>slightly (from an orginal approx. 3.2 X 3.6 cm to 3.6 X 3.9 - although
>it could just be the angle of the transvaginal scan).
>
>The doctor has suggested surgery (laproscopic) for removal or just a
>re-check in 6 mos. I have read some about ovarian cysts, but would like
>more info. Do I need a CA 125 blood test? What about Corpus Luteum
>cysts? What should I ask when choosing a surgeon? What about surgical
>complications/dangers (other than the usual w/anesthesia)? What are the
>chances/dangers of the cyst rupturing during removal?

A cyst that persists for at least 6 months does deserve evaluation, and a dx laparoscopy is the gold standard. Corpus Luteal cysts are not supposed to last beyond their own single cycle, so this is not a just a simple CLC, though they do sometimes persist, and that could be the ultimate answer. A CA 125 is virtually worthless as a screening test. The surgeon needs to be an experienced laparoscopist who can either handle the cyst if it turns out to be cancer (not likely), or who has someone available to assist if that occurs. The cyst may rupture, but that would only be an issue if it were a dermoid or some other type of cyst with "bad" stuff in it. Your surgeon will need to go over the specific risks of the surgery.

>
>I also recently (past 5-6 yrs?) have had a clear, thick, odorless,
>mucus-type discharge mid-cycle. My doctor said this was normal during
>ovulation, but it seems to have increased in amount and duration in the
>past couple of years. Also, my periods have increased in intensity and
>flow (but shortened in length) over the past couple of years. Will
>having the cyst removed help to lessen the above mentioned symptoms?

Probably not.

-- William D. McIntosh, MD, FACOG

This is for educational purposes only, and is not a substitute for consultation and examination by a licensed medical professional.

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In reply to: Sara: "4cm Neoplasm questions"

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