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Transabdominal And Transvaginal Ultrasound Done. Diagnosed With Ovarian Cyst. Concerned

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Posted on Thu, 16 May 2013
Question: Good Evening. I recently had a transabdominal and transvaginal ultrasound that demonstrated nabothian cysts with layering debris. There was also a 2.9 cm cyst in my left ovary with possible layering echogenic debris. I know what cysts are, just wondering about the layering debris. Is this something I should be concerned about? I do have a history of fibroids, having had 2 myomectomies and one UFE. In addition about 20 years ago I was diagnosed with an ovarian cyst, which resolved after taking birth control for three months. I did take birth control for years, stopping when I had the UFE in 2006.
doctor
Answered by Dr. Kulsoom Qureshi (1 hour later)
Hi,
Good evening.
Many thanks for your question.
You have not mentioned in your question, the reason for your scanning, do you have any symptoms or it was done as a routine work up. Anyway Nabothian cysts are quite common and are found on uterine cervix these are of no value unless you have any symptoms. Just make sure that you are regular with your pap smears and the results were normal.
One more thing I need to know is your mnstrual history. Are you still having periods or you have had menopause?
For your ovarian cyst, it is quite small but because of its charachteristics you need to undergo one test called Ca-125. It is a tumor marker & is usually raised if ovarian cyst is a XXXXXXX on, otherwise ultrasound follow up is usually enough.
Layering debris indicate that cyst has some contents inside which are giving echogenic shadows. This is an ultrasound marker which increase the significance of cyst. We need to have additional tests to make sure that cyst is benign.
Hope this clears your query. Please write back if you want to discuss this further.
Wish you good health.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kulsoom Qureshi (20 hours later)
I am in the process of menopause now, having very irregular periods. I did not have any symptoms, I had a pelvic MRI for a weak rectal muscle, and a lesion was noticed. My GYN doc did a followup pelvic exam and did not see anything but ordered the ultrasound to be sure. I was not aware that cysts could be anything other than benign. However, I did have a cyst in my left breast that was bleeding, but the biopsy did not reveal any malignancy. Could the two be related? Also I have a history of breast cysts and years ago had an ovarian cyst that resolved after taking birth control for three months. What could cause these cysts to be echogenic?
doctor
Answered by Dr. Kulsoom Qureshi (3 hours later)
Hi,
Thanks for your question & details.
Cyst could be benign as well as malignant. In younger women they are very rarely malignant but as we reach menopause percentage of malignant cysts increase to a certain extant so we need to be more vigilant in investigation & treatment.
This is very reassuring that your breast cyst was benign. I can't say that it is the same thing as your ovarian cyst but it may indicate that you have a genetic tendancy towards cyst formation especially if you have a family history of breast, uterine, ovarian or bowel cancers.
Some cysts just contain clear fluid and donot appear echogenic on ultrasound but others may contain blood or some solid contents inside them and appear echogenic on ultrasound.
Cyst with clear fluid are usually benign but those with echogenic foci & larger cysts need further tests to rule out malignancy.
Hope I have provided you with the desired information. Please contact back if you have any other question.
Wish you good health.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kulsoom Qureshi (9 minutes later)
What tests besides the CA 125 are usually performed to determine the status of ovarian cysts?
doctor
Answered by Dr. Kulsoom Qureshi (36 minutes later)
Welcome back.
The other most important test is a trans-vaginal ultrasound which you already had & this may be coupled with a doppler ultrasound to increase its sensitivity.
These two test are the first line tests done to calculate" risk of malignancy index" which is used these days to calculate the chances of malignancy & to plan management.
There are many other tumor markers & hormone levels that can be tested but they are not recommended in each & every case & your doctor may suggest anyone of them depending upon your clinical history.
After these tests your doctor may suggest you just ultrasound follow-up, cyst aspiration & / or biopsy or rarely you may need a laparoscopy or laparotomy.
This is too early to say anything but I have given you a brief insight into the probable line of work-up & management. Please write back if you have any more question.
Best of luck
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kulsoom Qureshi

OBGYN

Practicing since :1997

Answered : 1042 Questions

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Transabdominal And Transvaginal Ultrasound Done. Diagnosed With Ovarian Cyst. Concerned

Hi,
Good evening.
Many thanks for your question.
You have not mentioned in your question, the reason for your scanning, do you have any symptoms or it was done as a routine work up. Anyway Nabothian cysts are quite common and are found on uterine cervix these are of no value unless you have any symptoms. Just make sure that you are regular with your pap smears and the results were normal.
One more thing I need to know is your mnstrual history. Are you still having periods or you have had menopause?
For your ovarian cyst, it is quite small but because of its charachteristics you need to undergo one test called Ca-125. It is a tumor marker & is usually raised if ovarian cyst is a XXXXXXX on, otherwise ultrasound follow up is usually enough.
Layering debris indicate that cyst has some contents inside which are giving echogenic shadows. This is an ultrasound marker which increase the significance of cyst. We need to have additional tests to make sure that cyst is benign.
Hope this clears your query. Please write back if you want to discuss this further.
Wish you good health.
Take care.