Suspicious lesion on ovary

[Quickncjust4this]

I've had lots of issues with my ovaries over the years, including a torsion caused by some large dermoids.

About a year ago I had an ultrasound that showed more cysts, including a small dermoid on one side. This was noted as being odd, as I had my dermoids removed and they usually are growing from birth I was told.

I carried on getting pain so I was sent for an mri to check for endo or any other issues.

The MRI has come back showing that was previously thought to be a dermoid is a suspicious lesion. The radiologist put on the report that the features are concerning.

The gynaecologist has booked me for a ca125 test which I had on Thursday so waiting for the results.

I don't know how worried I should be really? The gynaecologist didn't seem overly concerned so I haven't been either but waiting for the result of the ca125 is making me anxious

Any advice or experience really welcome! Thank you.

Is your gynae a gynae oncologist? Some local general hospitals don't have one. If there's any talk of surgery, it would be better if you were referred to a hospital with a gynae oncology department. (Research actually shows better outcomes.)

The overwhelming majority of ovarian cysts are benign, but some fall into a grey area and you really need someone with the qualifications and experience to decide what isn't cancer as what is.

Thank you Thymeout, no she is not an oncologist.

That's good to know about the difference in outcomes.

I've been spending far too much time in Google and it seems that the radiologist would likely have been able to tell if this was another dermoid as was first suggested.

The plan is to have everything out anyway due to my endless issues with cysts, endo and severe PMS so I suppose it doesn't really make much difference. It just feels scary to consider the prospect of cancer

I think MRI's can tell whether a cyst has a blood supply, which might make it suspicious.

My history is that I had a v large ovarian tumour. Over 2 kilos. No symptoms except pregnant profile, but was still wearing same size jeans. Fainted in dentist's chair in the middle of root canal. Dentist called ambulance and I was reluctantly taken to A&E. Nurse noticed distended abdomen but junior doctor dismissed it and discharged me.

I went away and thought about it. Went to GP about a month later and she confirmed abdomen was indeed distended. She called it a cyst and said it extended as far as a full-term pregnancy. Referred me under the 2 week rule to local hospital. No Gynae-onc. Pretty useless consultant who refused to speculate until she'd seen scans. CT and MRI. MDT transferred me to St Thomas'. Consultant got CNS to ring me, instead of doing it herself. Started talking about suspicious cysts on omentum. Ca 125 of 130. I asked about surgery and she said no, it would be chemo first. I got 'a million apologies' for all this later. In the meantime, I had fine needle ultrasound biopsy.

So I turned up, thinking I would hear about chemo, and lovely surgeon's first words were 'Well, I think it's benign and will operate on ...' I gather local consultant got slap on wrist. Anyway, the upshot was a total abdominal hysterectomy and diagnosis of Borderline Ovarian Tumour, 'cured by surgery'. Not cancer. Never heard any more about suspicious cysts on omentum. Raised Ca 125 was caused by large tumour rubbing against other organs. Monitoring for 5 years back at local hospital with Dr Dud. Now 7 years since surgery.

From what I've heard, it's quite difficult to diagnose ovarian cancer from scans. The biopsy sampled the fluid round the tumour, not the tumour itself so as not to seed cancer cells elsewhere. It's the pathologist who does the definitive diagnosis. If an ordinary gynaecologist does the op to remove the cyst and it turns out to be malignant, there's a good chance of needing a second op by a gynae oncologist for staging.

So, positive points for you. 'Suspicious' lesions, cysts etc, just means needs checking out. It's not a definite diagnosis and raised Ca125 can be caused by lots of things, including endometriosis. Some women have it up in the thousands. It's mainly useful for seeing if chemo is working or not.

Fingers crossed for you. At least if you're in a grey area you should be sorted more quickly and not at the back of a long queue.

My little pennyworth. I had an hysteroscopy on 19th Feb to see why I was bleeding post Menopause (you have not mentioned your age). I am still bleeding. They said on my scan that they could not see my ovaries as I am post menopausal and apparently they shrink as you age.

I have put on 2 1/2 stone since December 28th. DO NOT let them fob you off. Keep going until you get some answers.

Thank you both. I'm still waiting on ca125 but have a gynae appt Monday so I wonder if I'll get the results then rather than in advance?
It's so tricky with ovaries isn't it? I'm only 40 and have spent the last decade having cysts of all types removed! The first 3 were dermoid - huge and all out in one surgery. Then I what was thought to be dermoid but was functional. Then two endometriomas.
I thought I had another big cyst back but us showed what was thought to be a tiny dermoid which wouldn't cause my current symptoms so had the MRI which has shown up this.
My symptoms are pain and a very swollen tummy. MRI also showed fluid but was thought to be from my endo or retrograde menstruation (Ive had an ablation).
I've mostly just been fed up with all but this is the first time cancer has been seriously considered.

You might find the Cancer thread helpful. It's for those with various lumps waiting for diagnosis as well. People pop in and are waved a cheery goodbye when they get an all-clear result, but lots continue to lurk and there's bound to be someone who's been in your position.

Are you near a specialist cancer centre? I think, if I were you, I'd be asking at what point in their investigations they would be thinking of transferring you.