What Does My MRI Scan Report Indicate?

Posted on Fri, 11 Dec 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 11 Dec 2015 Answered on

Mon, 28 Dec 2015 Last reviewed on

Question : MRI scan in January showed hemorrhagic cysts and with the one on my left ovary(1.9 cm) just advised to watch . XXXXXXX U/S showed the complex cyst on my left ovary (3.1x2.9x2.5) with internal debris. August U/S showed cyst still there but 2.4x2.0x1.8 cm with flow to left ovary noted. October U/S showed the cyst was still there on left ovary (still complex and now 3.1/1.5/2.4) with interval development of a nonspecific hyperechoic lesion. Both benign and malignant etiologies could have this appearance. Recommend MRI I just had a MRI scan done yesterday and it now shows Complex left ovarian cyst with thick walls and enhancing septation. Malignancy cannot be excluded. Adjacent nodule, likely endometrioma. No adenopathy. My doc is now sending me to a gynecologic oncologist. I am scared out of my mind. Can somebody please explain what is going on with me? I know thick walls and septation are not good, but how did a cyst that started out as a hemorragic in January get to this point? I also have been having weird hormonal changes like anxiety, and shortness of breath since August. Is this related?

Answered by Dr. Deepti Verma (15 minutes later)

Brief Answer:
Further evaluation needed

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
Both haemorrhagic cyst and malignant ovarian cyst have almost similar findings, with the cyst showing septations, internal debris ad echoes.
These two are differentiated on the basis of blood supply to the ovarian cyst and the level of the tumour marker CA 125.
The cyst in your case can be both malignant cyst or haemorrhagic cyst, hence the initial ultrasound appearance of hemorrhagic cyst was given.
Since the blood supply to the left ovary is increased, there are chances of malignancy, and hence you should be evaluated and managed by a gynecological oncologist.
I suggest you to be positive and optimistic.
Anxiety and shortness of breath are unrelated to this ovarian pathology.
Hope you found the answer helpful.
Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma

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

Follow up: Dr. Deepti Verma (6 minutes later)

Thank you Dr. XXXXXXX XXXXXXX Can you tell me what happens if the cyst is found to be malignant? My CA125 was at 70. Does a malignant cyst mean ovarian cancer? Also, could this cyst being malignant mean that the cancer may have spread? Im sorry for so many questions, I am unable to reach my doctor to ask these and feel overwhelmed with this diagnosis.

Thank you

Answered by Dr. Deepti Verma (9 minutes later)

Brief Answer:
Exploratory laparotomy

Detailed Answer:
Hi dear,if the ovarian cyst is found to be malignant, then you have to undergo an exploratory laparotomy, which is a major surgery to assess the extent of ovarian malignancy and further surgery is done accordingly. Chemotherapy is given post operatively.
Your CA 125 is definitely increased.
Malignancy means cancer.
It might have spread, but minor spread can be detected only on surgery, however there are no major spread as your MRI has not mentioned any lesion in liver, lung or any fluid in abdomen.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

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