Dermoid cyst: to remove or not to remove!

Posted , 15 users are following.

hi, i do hope someone could give me some advice.  i have a 3cm dermoid on one of my ovaries.  i've been seen by two consultants at two hospitals (went for a second opinion). 

one says conservative management is fine as i have no symptoms (although in the last 5 months i've had two mid-cycle bleeds which is why i was scanned in the first place) - consultant says this won't be to do with cyst.  he said the cyst has been with me since birth and is still relatively small particularly compared to ones they see in their unit.

other consultant wants to remove it but says she will probably remove all the ovary too because i'm nearly 45, have had my children etc etc and can be dangerous to have leakage from the cyst into the ovary.

i need someone to give me a definite answer as i'm finding it hard to know waht to do.

i would love to avoid surgery but there's always that nagging feeling of what if i leave it alone and then something worse happens down the line.

any advice is very, very welcome - thanks!

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  • Posted

    Hi I'm 37 next month and have 3 kidsI had a scan December it showed just over 3 cm dermoid cyst on my left ovary and scanned again Feb it had grown to over 5 cm I am having it removed on the 20th of April and they are looking for endometriosis ..I'm hoping they remove the lot as been in agony .. personally I think it would be best as it would only grow more and possible cause torsion
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  • Posted

    Hi there,

    I am no doctor/nurse, but I have had a 9cm x 8cm dermoid cyst just removed 10 days ago.  My doctor told me she would do her best to save my ovary because I am in my reproduction years and I have no child yet.  I asked her in what circumstances that a doctor would remove a patient's ovary?  She said if the cyst had become too large and inseparable from the ovary.   Or if the cyst had torsion or twisted, this would be an emergency and surely the ovary would be affected(or even died).  The good news is that this could eliminate the chance to develop ovarian cancer 'cuz you don't have it anymore.  That made perfect sense to me.  However, removing both ovaries will also mean removing the uterus as well.  This will make you start menopause right away.  I know it is a tough decision....

    - V

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  • Posted

    Here's my story. Hopefully it helps. First, I'd like to say that even though a cyst looks like one kind in tests, it could be a completely different kind as I found out after my surgery.

    I'm Tracy, 39 and have been trying to get pregnant.

    I had my right ovary removed in 2004 because it was engulfed in scar tissue. This was because ten years earlier, I had a cyst with a fertilized egg in it, in the wall of my ovary and it blew up like a grenade. I had two kids after that, though. Hours after my second baby was born in 2000, I had my tubes tied.

    In 2013 I had major surgery to repair my one remaining fallopian tube so I can get pregnant again.

    In December of 2014, on ovulation day, I started having excruciatingly sharp pain in the area of my only ovary, on the left side. The pain shot into the tip of my hip bone and radiated along the top of my pelvic bone, down the back and ended at my tail bone area. It also shot down my thigh on the same side. I went to the ER many times and all they saw were two small ovarian cysts. I've had recurring ovarian cysts since puberty.

    This pain caused me to basically become bed ridden. About two months later, a horrible burning pain started and this was in addition to the already severely sharp pain I was experiencing. This burning pain caused the hip bone pain to radiate down the front of my pelvic bone and ended in my pubic bone. So, now my pain was all along the top of my pelvic bowl, on the left side, from my pubic bone to my tail bone.

    After being pawned off from Dr to Dr, I finally found the most wonderful OBGYN surgeon. She was worried and did another ultrasound. One of my cysts had all of a sudden gone from being one inch to the size of a lemon. In the ultrasound, it looked like it was a hemorrhagic cyst. But, with the severity of my pain, my surgeon was worried my ovary was possibly twisted and dying. So, she got me into surgery the very next day. This was now three months after the pain started, March 3rd.

    She went in laparoscopically and found a little bit of a lot of things. The cyst was actually fibrous, caused by endometriosis. My fallopian tube was stuck by adhesions to my bowel. There was a bit of endometriosis on the right and left side of my uterus, but luckily not inside it. On my bowel, there was some scarring and a little endometriosis. Along with all that, my one remaining tube that was repaired in 2013, had been blocked by scar tissue.

    My amazing surgeon gently removed the cyst, scar tissue/adhesions, endometriosis, and unblocked my tube. She cured my pain, she's my hero!

    One reason why I wanted to post all of this is to let you know that it's possible to actually get rid of the pain and save your reproductive organs so you can still get pregnant. If course, there are different circumstances for some, but not for all.


    My surgeon was specially trained to remove ovarian cysts THE CORRECT WAY, with little to no damage to the ovary. Apparently, in medical school they're taught to just rip the cyst from the ovary wall, which will cause damage, scarring. My surgeon went to additional schooling, to be trained as a specialist, to gently tease cysts away from the ovarian wall and preserve the egg reserve as much as possible. It takes a long time to do such delicate work, but if you still want kids it's definitely worth it!

    One other thing I want to mention is, each month when an egg is developing in the ovary, it develops inside a cyst. But, at that point it's called a follicle. Once you've ovulated, the follicle is then called a cyst. They typically go away on their own. I've had them linger a little, sometimes for months, since I started puberty.

    Anyway, my first period since my surgery started a couple days ago. For the first time, I'm feeling cramps the way normal women do. I am having some ovary pain, but that's normal this soon after surgery. Also, my period is heavier than I've ever had, insanely heavy. But, that's normal after this surgery as well.

    I hope this info helps put your mind at ease and educates you a little about what you may be going through. There's hope! I personally recommend the laparoscopic surgery, but only if you find a surgeon who specializes in this sort of thing, one who's had additional training in making sure they're as careful and gentle as humanly possible. Laparoscopic will cause far less internal scarring than major surgery. I read that something like 80% of people will have internal scarring after major surgery. That's why, no matter what kind of surgery you have, you need to be extra careful about not using your abdominal muscles for about 6-8 weeks. If you need to cough, sneeze, vomit, etc, make sure you have a pillow you can press on your belly to prevent any major abdominal movement. That can help prevent adhesions like I had.

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    • Posted

      Sounds like you have been through it! I have just spent 5 days in hospital and came home with the same pain I went in with and had doctors just rolling their eyes at me (junior doctors from gynae is all i saw!!).

      mine started Saturday night with pain right around my belly button and gradually got worse. By the time I went to a and e it started lower down on my right side. At first appendicitis was suspected but quickly ruled out by ct scan where they saw cysts on my ovary. The consultant I saw was not from gynae and said one of the cysts was quite large and he wanted me to have another scan ultrasound. This showed endimetriosis in my womb, the cysts and fibroids. Then the consultant said as it was not his area I was to see at least a registrar from Gynae. He said to his team to make sure if this. All I saw was a young junior who insisted that the cysts were tiny and woukdnt cause the pain I was describing. I had been bleding fir 3 days too, but not like a period, it was only when i went for a wee, lots of fresh blood, no clots like I nirmally get in a period. I had out a pad on ad it stayed bone dry. I wanted to know wy I was bleeding with no flow, ahe said just an abnormal period. I am 47 so that can happen. I argued that a period isstill a flow of blood. This is only when I go for a wee! She examined me and said its from the vagina, its a period. I said yeah i know its from the vagina (der) but is it necessarily from my womb?! She just kept saying, yes its from your vagina! Oh and had retorted at me "why are you wearing a pad then"? When i said my pad was bone dry, as if she did not believe me!! I am lying in bed now still in pain, the bleeding has now stopped but I just do not know what to do!

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    • Posted

      That's exactly what was happening to me right before my surgery. I'd bleed but only when I wiped after peeing. So, I didn't need a pad.

      Just so you know, you cannot see endometriosis in an ultrasound. Rarely it can be seen in an MRI, but the only way to truly diagnose it is under a microscope after it's biopsied during laparoscopy.

      I would find a specialist, it sounds like the people you've been seeing are f'n morons.

      I truly feel for you!

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    • Posted

      I would love to talk with you I have been through he'll and back finding my own doctors and been in pain worse then having a baby! My name is Amber

      Just found out my syst is bigger then it was before and I also have other but no one said this coukd cause pain

      Please contact me or message back in I'm las vegas and want to find the right doctor

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  • Posted

    I had a 14cm Dermoid Cyst removed nearly 6 months ago now!! I had to have open surgery and was cut open right across my lower stomach but I'm so glad I did. My cyst was measured at 8.9cm in April then at 10.5cm in July then from that to 14cm when I had it removed in October.

    I recovered well from the op and I am still seeing the gnaecologist as I am still experiencing that dull achy feeling when I had the cyst so I had further ultrasounds and trans vaginal scans and they said I had a cyst on each ovary this time but they were only blood filled and should pass through naturally. I just worry I will have another cyst that grows and if so I will want my ovaries removed I'm only nearly 31 and no children but I can't keep thinking and worry about cysts and surgery. If you want to know anything about the surgery I had feel free to ask any questions or message me. I honestly thought the surgery would be a lot worse than it was my surgeon was amazing smile

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    • Posted

      They thought my cyst was blood filled, hemorrhagic. But, when my surgeon got in there, she found it was fibrous which is caused by endometriosis.

      Also, be really careful and self aware. Since you had major surgery, instead of laparoscopic, you will most likely end up with internal scarring/adhesions. That's what happened to me after every major abdominal surgery I've had. I also read that something like 50-80% of people who've had major abdominal surgery will have scarring and adhesions.

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