Dermoid cyst referral to gynaecology

[Blueberryme]

Following a bout of severe abdominal pain last September I was diagnosed with a dermoid cyst and multiple small fibroids in December via ultrasound. I had a follow up ultrasound in early Feb which had pretty much the same findings and so I have been referred to gynaecology. It is my understanding that dermoid cysts can’t be left unlike other cysts often can.

I just happened to be looking on the NHS app and noticed the referral letter to gynaecology which states that I am still having regular periods - but I’m not. I’m in perimenopause and periods have been irregular for about two years now, and now I haven’t had a period at all since November. I still get regular niggly abdominal pain where the cyst is.

Should I tell the GP to update the letter to gynaecology that I am not having regular periods, as I am worried that the referral will be rejected on a ‘wait and see’ basis? I believe that post-menopause it is more risky to have these cysts and right now I’m over 3 months late and counting, and I don’t want to see a referral rejected and then battle for another referral at a later date when I could possibly be post-menopausal by then. I’m nearly 52.

Who have you been referred to? I'd call the consultant's secretary directly, and tell her the letter is wrong, that you've moved into peri but that the dermoid still needs dealing with. If they want you to go back via your gp, they will tell you.

Don't wait. Dermoids can be very nasty as I found. My gp missed mine and I ended up an emergency admission in a&e at 3am, in more pain than I can describe. By then it had twisted, I had a raging abdo infection and passed out in triage. I made the morning surgical list, followed by a week in hospital and seven weeks off sick. I lost an ovary and tube. By that point whether I was still having periods or not was irrelevant.

@Meadowfinch all I can see on the NHS app is that the referral to gynaecology has been done and it shows a letter of the details of who to contact if I haven’t heard by a specific date etc.

I just don’t want a scenario where they look at it and think meh the cyst isn’t that big and she’s having regular periods so I can been delayed for another 6-12 months etc.

I had severe pain suddenly (9/10 pain level) about 6 months ago - it only lasted about 5 mins but it was shockingly painful, so I saw the GP who referred me for ultrasound. I am still getting minor niggles at least every few days, if not everyday, so I’m worried it will happen again and could end up as a scenario like yours.

Call the contact they have given. That will probably be the consultant's secretary.

I was 32 when I had mine. I'd keep chasing them. It can twist at no notice and then you will need surgery immediately. They prefer to deal with it under scheduled surgery. A blue-light emergency admission is in no one's interest.

I would ring the gynaecologist’s secretary and provide this extra information and push to get seen earlier, particularly if you are symptomatic. Menopausal status is also important as you say in this situation. The NHS app is very useful to access accurate information. Have you had any blood tests? They may have tested your FSH level (follicle stimulating hormone) if you have a look. There was uncertainty over my menopausal status and I had a look at that result on the app and it was at post menopausal levels which I told the gynaecologist/GP. It does pay to be proactive because this was then included in notes.

There was a gynaecology emergency that came into our ward when I was in day surgery for a uterine polyp removal and the poor woman was in agony.

Yes, by the time they put me under, I wouldn't wish that kind of pain on anyone.

OP is thankfully in a much better situation, she and her consultant know what is wrong, how urgent it is and what needs to be done. They won't let it get nearly that far. I'd expect a date within the next couple of weeks. And OP knows to go straight to a&e if there is a sudden deterioration.

Good luck OP. xx

Thanks everyone, I will call tomorrow.

@fluffythecat1 the GP referred me for blood tests and I got the link on 3rd Dec and finally had my appointment on Friday just gone - to find out that she hadn’t submitted the blood tests request at all! So they turned me away obviously - I was so upset as I’ve waited 3 months just for a blood test, so I have no idea what she was referring me for. I am pre-diabetic so I know I was having my HBA1C checked.

GP’s receptionist is sorting out tomorrow it I suspect my hormones are all over the place. I haven’t had a period since November, which is the longest gap I’ve had so far in recent years. I have multiple small fibroids too.

Yes, definitely worth chasing them and getting them to sort it. Unfortunately, the NHS can be a blunt instrument and miss things, I was on an urgent suspected cancer referral pathway (am fine), which stipulated that I should have a CA125 cancer marker blood test done before seeing the gynaecologist and that was the one test they didn’t do. 🙄
Other things like BMI are checked with a pre op, if you are looking to have the cyst potentially removed, along with blood pressure, any breathing difficulties like COPD and asthma etc.

If you are post menopausal with a dermoid cyst then you should be seen within 2 weeks as per NICE guidelines iirc. You are likely to have regular 3 monthly scans or surgery to remove it as you no longer have periods in my experience.

@MrsCarmelaSoprano I’m in Peri-menopause but not post menopause and yes I’ve heard there is an increased risk of cancer in post menopause.

As it’s now coming up to nearly 4 months with no period/spotting whatsoever I am concerned about being fobbed off now if they think, according to the GP referral, that I am still having regular periods. if they so we’ll re-visit in 6-12 months then it’s possible I may be in menopause by then. I am also getting regular niggling pains, so I will be ringing the GP and hospital to update them on the above re periods.

Keep on at them even though you might have to wait,I had to wait 18 months for surgery even though I was on the urgent list.