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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11259
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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my 33 Yr old wifes in the philippines just had this ultrasound

Customer Question

my 33 Yr old wifes in the philippines just had this ultrasound report.....
THERE IS A WELL -DEFINED,85 X 72 X 58 MM,COMPLEX,PREDOMINANTLY CYSTIC MASS IN THE RIGHT ADNEXA.IT IS LARGELY CYSTIC FILLED WITH MIXED LEVEL ECHOES RANGING FROM LOW TO HIGH LEVEL ECHOES THAT ARE AVASCULAR ON COLOR FLOW MAPPING. THE INTERNAL HIGH LEVEL ECHOES SHOW DEPTH-DEPENDENT SONIC ATTENUATION SUGGESTIVE OF FATTY COMPOSITION. THE LEFT OVARY IS UNENLARGED MEASURING 44 X 35 X 26MM WITH A DOMINANT ANECHOIC FOLLICLE MEASURING 16 MM IN DIAMETER.
RIGHT ADNEXAL COMPLEX CYST SUGGESTIVE OF A DERMOID CYST.

my question is:- Bearing in mind this cyst is the size of an orange,are there any alternative treatments(hormonal, herbal etc) that are realistically worth the risk of trying first rather than surgery. I am concerned that it might burst with disastrous consequences.
Submitted: 4 years ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 4 years ago.
There are no real alternatives to surgery. A dermoid cyst is a benign ovarian tumor that will not go away using herbs or hormones. It contains multiple types of tissue, often with hair, fat, cartilage and teeth. These won't dissolve or go away without surgery. It's not difficult surgery to remove this, which would most likely involve removing the right ovary, since it will be difficult or impossible to remove the tumor from the ovary. Her left ovary appears normal, and will take over normal ovarian function. I hope that's helpful.
Customer: replied 4 years ago.


If surgery is delayed,what are the risks of a large cyst like this bursting and what would the consequences be ?


what are the possibilties it may be malignant and therefore the sooner its out the better ?


th reason i asked was , I was told by a regular doctor, who is no expert, that here in Andorra that in general with someone this young they try to save the ovary by first trying hormonal treatment to reduce size.


 


could this cyst be a drain on energy and eplain her lethargy and bad moods ?


what are the risks of an operation to remove it,and does it require a surgeon whithe very specialist skills/experience in this field?

Expert:  Dr. Norm S. replied 4 years ago.
Although a dermoid cyst can burst, it's fairly unusual. I don't think I've ever seen it during my career. The consequences would be abdominal pain which would probably require emergency surgery.

There is a small chance that a dermoid cyst will be malignant, probably 1-2%. This won't be known until the dermoid is removed and examined microscopically.

Hormonal treatment is good for functional ovarian cysts (cysts related to ovarian function). Hormone treatment will have no effect on a dermoid cyst.

A dermoid cyst should have no effect on her energy and bad moods.

The risks of any abdominal surgery are bleeding, infection, anesthesia complications, and injury to other organs (intestines, bladder, etc). It would be best done by an OB/GYN doctor who is skilled in abdominal surgery (any well trained OB/GYN doctor). If so, the risks are small.