u/BiteSure8769 — reddlx

Hello and sorry for the long post, but context and background is a bit dense in this case. And I'm kind of spiraling. Edit: TL;DR at the end of the post.

I had an open myomectomy and an open cystectomy simultaneously 6 weeks ago. Going into surgery, the cyst was believed to be a 7cm dermoid cyst based on imaging. And the fibroid was HUGE, anchored on both the outside and inside of my uterus.

I only have one ovary. I had an adenoma at 25 which led to me losing my left ovary. But surgery was “successful”, the ovary was spared, and recovery has been excruciating but almost complete.

So, naturally the other shoe had to drop.

My doctor noted two important things when I spoke to her after the surgery though: 1. The cyst ruptured while she was handling it and from the contents, she believed it was actually a chocolate cyst and not a dermoid cyst like we thought going in. 2. A week post-op, she called me and said that pathology of the cyst came back as it being a Serous Borderline Ovarian Tumor.

She referred me to a gynecological oncologist and ordered a pelvic CT for further imaging.

I had to obviously wait a few weeks before I was well enough to lay flat for a CT etc, but I just got that done and saw the oncologist a few days ago.

The CT showed that I have another 4cm mass (presumably another SBT) on that same ovary that my gynecologist somehow missed during open surgery.

When I met with the oncologist, she immediately started discussing her plan to go in and remove it herself and I honestly started hearing white noise because how on earth did I just crawl out the other side of an excruciating and honestly traumatic experience and am being told I'm about to have to do it all over again?

She also said that, on a regular basis, the chance of reoccurrence is 25% which is troubling with only one ovary to gamble with. But because the tumor popped and was introduced across my pelvis, each of those cells that spread is now another chance of growth. And each reoccurrence comes with the risk of coming back as "full blown cancer", not just borderline. If I wasn't young and only had one ovary, her recommendation would've been to just remove my right ovary and fallopian tube altogether.

I'm barely recovered from the first surgery, and still on leave from work. I don't know how I'll tell them almost immediately after my return that I need to take another month long leave. I'm also worried about what my scar tissue situation and all the complications that come with it are gonna look like when everything's said and done.

TL;DR: I only have one ovary after losing my left one a few years back to an adenoma. The pathology of a recent ovarian cystectomy on my one remaining ovary came back as a serous borderline tumor(which ruptured during surgery). CT scan 5 weeks post-op revealed that my gynecologist missed a second ovarian tumor in the exact same area. Oncologist is now advising going in to remove the second tumor herself.

I'd never heard of this type of tumor before and the duality of it being serious/not as serious has me kind of stuck with making a decision of maybe holding off on the second surgery if there's a chance of a later oophorectomy and forced menopause anyway? Does anyone think this is a case for negligence on my gynecologist's part for missing it? Any advice would be greatly appreciated!!

Hello,

Never posted here before, but I'm kind of spiraling. Sorry for the long post, but context and background is very important and a bit dense in this case.

The stakes for the surgery were very, *very* high for me as I only have one ovary. I had an adenoma at 25 which led to me losing my left ovary. I can't even verbalize the state of fear, anxiety, and terror I was in the entire month leading up to my surgery last month. I was scared to even move around most days fearing there'd be ovarian torsion before the surgery and I'd lose the remaining ovary, but also terrified and dreading the surgery itself believing that I'd wake up with no ovaries and in surgical menopause at 30 years old.

Thank God the surgery (supposedly) went perfectly. My gyn was able to remove the cyst and I'm now almost fully recovered after an extremely painful and slow-going six weeks.

The doctor did note two important things when I spoke to her after the surgery though: 1. The cyst ruptured while she was handling it and from the contents, she believed it was actually a chocolate cyst and not a dermoid cyst like we thought. 2. A week post-op, she called me and said that pathology of the cyst came back as it being a benign Serous Borderline Ovarian Tumor.

She referred me to a gynecological oncologist and ordered a pelvic CT for further imaging.

I had to obviously wait a few weeks before I was well enough to lay flat for a CT etc, but I just got that done and saw the oncologist a few days ago.

The CT showed a “redetermined right ovarian dermoid cyst and complex fluid in the pelvis”. Basically meaning that the CT showed the same ovarian cyst that I supposedly just had removed a month prior and the complex fluid is from when it ruptured. I thought that had to be an error and I went into my appointment with the oncologist believing she'd clear things up and say the same, but NOPE. Turns out I have *another* 4cm mass (most likely another SBO tumor) on my right ovary, near the original one that was removed that my gynecologist somehow missed during *open* surgery.

The oncologist immediately started discussing her plan to go in and remove it herself and I honestly started hearing white noise because how on earth did I just crawl out the other side of an excruciating and traumatic experience and am being told I'm about to have to do it allll over again???

She also said that, on a regular basis, the chance of reoccurrence is 25% which is high enough. But because the tumor popped and was introduced across my pelvis, each of those cells that spread is now another chance of growth. And each reoccurrence comes with the risk of coming back as full blown cancer, not just “borderline”. If I wasn't so young and only had one ovary, her recommendation would've been to just remove my right ovary and fallopian tube altogether.

By chance, my 6 week post-op appointment with my gynecologist was the following day (yesterday) so I went to her, armed with questions mainly about “how tf did you miss a second 4cm tumor staring right at you during open surgery?!” And when I tell you she had absolutely *zero* explanation or accountability. Her reaction was to first pretend she didn't already get the CT results and oncologist's notes, and then just say how “shocked” she was when read the CT report with such a monotonous voice. I asked how it could've been missed and her response was again to just say she was shocked. I asked if she checked the surrounding areas before she closed and she said “of course” and that was literally it. No “I have no idea how this could've happened” or “these things tend to hide” or anything that made a lick of sense. Just *nothing.*

I don't even know which way to go now. After all this, I'm basically back at square one like I was in February: with a mass on my one remaining ovary that needs to come out, fears of torsion and rupture, fear of losing it in surgery and menopause at 30. Actually it's even worse, I'm barely recovered from the first surgery, I'm still on leave from work for another 2 weeks. Then I'm gonna have to go back and tell them almost immediately that I need to take another month long leave. I also can't even think about what my scar tissue situation is gonna look like when everything's said and done.

Has ANYONE been in a situation like this before? Any advice? Does anyone think this is a case for negligence on my gynecologist's part? Any advice would be greatly appreciated!!