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Small COMPLEX SEPTATED OVARIAN CYST. Should I worry?

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Hello. Could you let me know if a 2.6 X 2.5cm complex septated cyst of the ovary is worrisome? I am 29 year old female. No kids.

The report states "small complex septated cyst of the left ovary measuring 2.6 X 2.5 cm. An enhancing internal septation is seen with maximal thickness of 2mm and there is peripheral enhancement surrounding the margins of the cysts within the ovarian soft tissues. "

Any information would be helpful!

Category: OBGYN

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Category: Infertility Specialist
 31 Doctors Online

Hello,
Thanks for posting your query at DoctorSpring.com
Actually what are your symptoms ?
Why was this scan done ?
Was it a transvaginal scan ?
Can you upload the report ?
How are your menstrual cycles, what problems did you have that led to the scan, have you been pregnant before, what is your height and weight ?
Please write back with these details.
All the best
Please feel free to discuss further.
Regards.


Patient replied :

Hello and thank you for responding..

I currenlty have no symptoms of pain regarding the fibroid or cyst. The reason the scan was done was to check for the size of the fibroid and exact location, as my husband & I want to begin having children soon. It was an MRI scan. I unfortunatley dont have a way to upload the report but can typ eof the impression..

1.Single firboid measuring 3.2 cm withing the uterine body. Intramural causing mass affect upon the inferior endometiral lining.
2. Complex septated cyst of the left ovary measuring 2.6 X 2.5 cm. short term followup pelvic ultrasound is advised for reevaltuion to assess for resolution to exclude aggressive/malignant process.
3. Multiple bilateral thin follices
4. Trace free fluid within the pelvis may be physiologic
5. Small to mildly prominent right benign appearing bilateral inguinal nodes. No pelvic adenophathy detected.

My menstraul cycles were painful in july/august which prompted me to go to the doctor and that is when they found the fibroid. The last two months though they have been fine and they are always on time (average cycle 29-33 days). I have never been pregnant.

My height is 5'6 and my weight is 135lbs. My doctor didn't seem to concerned with the cyst but since it says short term follow up I was concerned. I do have an ultrasound next week but would like to know if this is likely cancer in someone my age...Also if you could explain what the thin follicles mean. At the time of my MRI I was on cycle day 14 and was just a few days away from ovulation.

Thanks for your help!


Hello again.
Let me address your queries and try to be more clear this time.
Regarding the fibroid, that is impinging ( pressing upon ) the lining of the uterus, and does not interfere with conception per se, but increases your risk of miscarrying, it is wise to have a myomectomy ( removal of the solitary fibroid ) done.
Regarding the cyst, it is least likely to be malignant at your age, nor are there any supportive features on the MRI, of course it would be best if you could upload the ultrasound scan report also when you get it.
It is most likely to be an infective or endometriotic cyst, and on follow up, it would be clarified.
If the size or nature of the cyst changes ( increases ), then further investigation is warranted.
Right now the best approach is to follow it up after some months ( 6 weeks to 3 months ).
Regarding the thin follicles, it is a normal finding, as the ovaries are studded with small follicles normally.
However, what is not normal, is that on cycle day 14, a dominant follicle ( that would ovulate ) should be visualized, was not seen.
That points to lack of ovulation, or anovulatory cycles, which might be the reason for your inability to conceive.
I would advice follicular monitoring ( serial tracking of the egg follicle via ultrasound scan ) next month too to confirm if this is the case.
If yes, you would need follicular stimulation in the form of drugs or injections.
It is best to proceed with interventional surgery for the fibroid ( and the cyst, if it gets bigger or changes the texture ominously ) before planning a child.
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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