How do you find out what the complex cyst is?

In order to see what type of cyst it is, sometimes an ultrasound will clear that up, but I see you already did that. If the cyst on the ultrasound has white inside of it, it's probably a complex. If it is black, it's probably a simple cyst. Your doctor should have told you what type it is by looking at the images.

However, in my case, they misdiagnosed my cyst. They had originally said it was a simple, but three months later it turned out to be a dermoid that needed surgery!

Sometimes they can't tell what the cyst is, and the only way to find out what type it is would be surgery.

I think it's good you're switching OB's. This one seems a little lazy! Hope I answered your question, and I wish you the best of luck! -Kellin

I know it's a 2.4cm complex cyst. I have a bunch of smaller simple cysts as well, from the pcos. But I don't understand why it wouldn't have said what kind of complex cyst. Oh I also have a small cyst on my cervix. Had to Google that as well.. She didn't even mention that one... Back in 2006, I had a complex cyst in my thyroid. They ran a bunch of tests. I ended up having the right side of my thyroid removed along with the cyst. Because I was young and it was a solid cold cyst, I think they were worried it might have been malignant. I do not remember what it came back as.. I don't know if that has any correlation.

My dr is horrible! Endocrinologist treat the cause of pcos, and obs really only treat the cysts that linger from pcos. She didn't tell me that either. So after my results, I'm going to hunt for a endo.. I always leave her office with more questions than answers. My last appt, I mentioned a bubble popping sensation that randomly happens. She giggled and said "let's see what the ultrasound says"... She giggled!? I've had that since my son was born.. Just ridiculous.

They often can't tell for definite with a complex cyst until it's ultimately removed and sent to a lab. Often they will monitor ones under 5cm as sometimes they will often disappear of their own accord x

A simple cyst is a functional cyst = just liquid inside (black on ultrasound), either follicle cyst prior ovulation before it bursts/releases the egg or luteal cyst

or

a luteal cyst, it can have blood in it after ovulation. (hemorrhagic cyst)

Those cysts are normal up to a size of 2-3cm.

Simple cysts can even be bigger and could influence the hormone production of the ovary or become heavy (twist), hence are monitored and sometimes removed (even just being a functional, benign, simple cyst) if they are persistent.

Sometimes the fibrin (from blood clotting) can give little white stripes in ultrasound pic in an otherwise normal hemorrhagic simple luteal cyst.

So it is hard to see on ultrasound, if the 'structure' in an otherwise 'black = liquid' cyst,

is just normal fibrin of a luteal (hemorrhagic) cyst,

or clots from multiple bleeing in an endometrioma (which is benign, but not normal, not functional and never will disappear on its own)

Clear 'white' structures are growths, which can be benign or malignous. (sometimes though fibrin/blood clots can be mistaken for growths, always depends how big they are)

Whenever any structures (white) are found in a cyst,

it is called 'complex', since it is not simply only liquid.

As I said beforehand there is a range of reasons why there is something else inside and often enough very hard to distinguish one reason from another.

Ultrasound and MRI give clues as what the structures can be.

Ultrasound has the benefit of doing doppler mapping (blood flow measurement)

Only a removal and histological (microscopic) assessment can determine 100%, what exaclty is inside, if it was growth.

BUT sometimes waiting and monitoriing helps, too. If it was functional: it will disappear most likely on its own.

My story: I had a 3cm simple cyst, year later the same ovary had a 5cm simple cyst, a year later it was 9cm, so called simple cyst since gyn doc only saw black liquid, time to remove it due to size anyway, in the hospital same week the ultrasound in 9cm cyst revealed a 'growth' inside (some white structures, not fibrin clot looking), that did not look benign, said doc (?)....I brushed them off to not do pre-assumtions and rather do a good histology of removed tumor before explaining removal of ovaries, uterus, lymphnodes. I got no MRI prior. I wanted to know grading, type before going on with invasive surgery. Also could see it sitting nicely inside a cyst, didn't look invasive, boarder crossing, infiltrative.

And what was it? It was benign: a dermoid cyst, teratoma with bones, nerves, hair and all. (which could be seen during operation, so hopefully even with preassumtion of cancer would not have gone on with invasive surgery.)

I am therefore not a fan of any 100% fix diagnose/assumption prior histology of 'growth' in a complex cyst.

Indications, likelyhood, ok, but nothing is 100%.

I always watch during gyn ultrasound, too. You can see if it was a nice, encapsuled, sharp boardered, black (liquid) blob. That's always a good sign in general.

A simple harmless cyst should be well be distinguishable from a complex cyst.

Once it is a complex cyst, there is only histology that can determine, what exactly is inside if it didn't look like fibrin/clotting but growth.

Good luck and keep printed records of your results yourself. You are entitled to have a print out of each and every report that is ever made.

Hope you get hold of the ultrasound report and can read for yourself, if it was only a simple cyst.

All the best!

I appreciate everyone's feed back . It was extremely informative. Definitely better than my doctors!

My results came back, I read them myself. My complex cyst is gone. Yay!! My right ovary size has gone done, my left one (with the cyst) is way down! All the little follicular cysts are still there, my right one has more than before . I was hoping that would have changed the most. It did mention a lesion. So now I guess on to the endo who can help get all my horomines under control, because obviously bc isn't a good option considering the above.

Lauren,

Good girl!! Treated so poorly by another woman no less BAH!

Great instincts and good plan. Since you have a GP you trust make sure you provide feedback to him/her.

Yes, if you get a copy of the radiologist report it should say type if determined. Sometimes additional testing is required to determine or confirm.

I went through 3 Drs. before I found one who I felt was professional and cared enough to be a health partner. (My term) 3 dismissed my symptoms the 4th gave me a diagnosis and treatment plan that made sense. All in my first visit with him and the test results that I had gotten from the other Drs. who had never even looked at them! Of course he ordered additional scans that supported his diagnosis.

So keep up the fight for your health! Sorry about the PCOS. It can be managed, depending on severity and ask for a referral to a specialist. You need experience and compassion on your side.

The techs aren't supposed to tell you anything so don't take that personally. They get feedback on Drs. all the time but they aren't diagnosticians. That's why a radiologist reads the scan and writes the report. I too think that's too much distance and too many hands but that's how it works. In my opinion a good Dr. will review the report and scan with you personally in the follow up.

Your instincts are spot on, so keep up the good work! Get your referral and keep us posted.

XXXX

Oh, I should have mentioned before lol. My testosterone is high. Its like 80 something. Im hoping the endo can treat that. My other hormones were fine. It was almost missed that my testosterone was high. The testosterone level was the deciding factor in the pcos. But I have no clue what the endo might say. Obviously the birth control isn't keeping the cysts under control like the ob thinks it will.