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Premenopausal With No Uterus. On Triple Therapy For RA. Pelvic Scan Showed Ovarian Cyst. What Treatment To Follow?

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Posted on Thu, 14 Nov 2013
Twitter Thu, 14 Nov 2013 Answered on
Twitter Sat, 7 Dec 2013 Last reviewed on
Question : I am premenopausal 57 year old Australian woman with no uterus but with ovaries. No history of endometriosis but sister and daughter have it. I have had strange pelvic scan as followup to large ovarian cyst six weeks ago. See results in uploaded report. I have rheumatoid arthritis and on triple therapy. Have polycystic ovary syndrome and hypothyroid. What would you advise to do about this if I were your patient?
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Answered by Dr. Krishna Kiran Kannepalli (15 hours later)
Brief Answer: Better to send cyst fluid for cytology. Detailed Answer: Hello. Thanks for the query. You did not mention the previous scan findings. Has the lesion increased or decreased. It is better to get a CA125 and FSH level (to know the menopausal status). I would do these tests on you. If the CA125 is normal ,simple needle aspiration by the abdominal or vaginal route can be planned - the aspirated fluid can be sent for cytological examination. However, if the CA125 level is raised,a surgery to remove your ovaries,the cyst/hydrosalpinx,a few lymph nodes,a fatty layer called omentum and peritoneal fluid should be planned. Your gynecologist will know about the tests. Hope this helps. Let me know if you need clarifications. Regards
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Krishna Kiran Kannepalli

Oncologist, Surgical

Practicing since :2004

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Premenopausal With No Uterus. On Triple Therapy For RA. Pelvic Scan Showed Ovarian Cyst. What Treatment To Follow?

Brief Answer: Better to send cyst fluid for cytology. Detailed Answer: Hello. Thanks for the query. You did not mention the previous scan findings. Has the lesion increased or decreased. It is better to get a CA125 and FSH level (to know the menopausal status). I would do these tests on you. If the CA125 is normal ,simple needle aspiration by the abdominal or vaginal route can be planned - the aspirated fluid can be sent for cytological examination. However, if the CA125 level is raised,a surgery to remove your ovaries,the cyst/hydrosalpinx,a few lymph nodes,a fatty layer called omentum and peritoneal fluid should be planned. Your gynecologist will know about the tests. Hope this helps. Let me know if you need clarifications. Regards