I have pelvic pain, and my ultrasound shows a complex cyst in my right ovary. Is this cancer?

Question

Hi doctor,

I have been having pelvic pain for the past few months. I recently felt nauseous and overly tired (even after taking my Adderall for my ADHD). Pelvic discomfort and pain that even moves towards my back, pressure, and bloating. And I have not had an appetite and lost 20 lbs. I have been feeling this pain for a few months now. Two months ago, I had gone to ER suspecting IUD migration. I got an ultrasound a few days ago because it was supposed my IUD had migrated, but they found a complex cyst in my right ovary. I am concerned, but they will not see me for another eight weeks despite cancer running in my family. I was also told I have endometriosis, and I work as a surgical technician at my hospital and saw my ultrasound. The cyst looks very off to me. I also take Prozac, and sometimes I had taken Tylenol, Midol, etc. Kindly help me.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and also have looked at the images of the USG (ultrasonography) you have provided (attachments removed to protect the patient's identity).

USG shows a right-sided complex ovarian cyst. Also, based on your history, you have lost your weight as well as appetite. These symptoms and along with USG findings, are worrisome. But that does not mean this is due to cancer. There are no other classical findings of cancer like ascites, papilla, septations, which would point towards a more ominous cause.

The most common differential diagnosis for such symptoms at your age is endometriosis or functional ovarian cysts, which are not completely ovulated. And that is why a follow-up USG is needed to see what is the status of that cyst. Meanwhile, a blood test of tumor markers like CA-125, AFP (alpha-fetoprotein), and beta-hCG (human chorionic gonadotropin) can give some clue towards the cause of that cyst.

Here I would also like to know which cancers run in your family? A family history of breast or ovarian cancer would necessitate a more aggressive evaluation in your case. Even then, 20 is too early age for usual ovarian cancers. And only ovarian cancer common at this age is a germ cell tumor, which can be picked up in most cases with blood tests for tumor markers.

Right now, I would consider doing blood tests for tumor markers and then get a follow-up USG based on these results. If follow-up USG still shows similar findings, you may need to undergo an MRI (magnetic resonance imaging) to resolve these findings.

I hope this was helpful.