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Hi, I have been feeling severe pain in my left lower abdomen. Because I have also had heavy bleeding during my last two periods I have decided to see my gynecologist. He did an ultrasound exam and told me that I have some kind of a cyst on my left ovary. He also said that because of the symptoms I have been experiencing he believes that the cyst is a complex cyst caused by endometriosis. I was very surprised to find out that I had so many problems with my ovaries. However, the doctor did tell me that he has to do some more exams to make a conclusive diagnosis. This is not very comforting and I am very worried for my health. Could you tell me something more about complex cysts? I would like to know what I am up against.

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Hi, I am very sorry to hear about your problems with the ovaries. The pain you are feeling and heavy bleeding during periods are probably caused by endometriosis. This is a condition in which uterus lining grows outside the uterus, for instance in or on your ovaries. This endometriosis tissue can form a cyst that is because of its dark brown color called chocolate cyst. The term complex means that the cyst is filled not only with fluid, but solids also. Now for the bad news. Complex cysts are in very large number of cases malignant. I suppose that the doctor didn't want to worry you before he is completely sure about your condition. The test that he is talking about is probably a blood test that is used to determine the amount of a tumor marker specific for this kind of cyst. If it turns out that you have elevated level of this marker, the doctor will perform a laparoscopy to remove the complex cyst. However, you should also know that only when the cyst is removed the definite diagnosis can be made. So until you have gone through all of these stages there is no way to know if the complex cyst is benign or malignant. I hope everything turns out for the best.
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For the original poster... It is false to say that a large percentage of complex cysts are malignant. In fact, 95% of complex cysts are benign and a reduction in size is seen within just two menstraul cycles in most women. In fact, Complex cysts are common. Do not worry! Just make sure to follow-up with a qualified GYN.

The "tumor marker" test (CA-125) is also not a reliable test in diagnosing Ovarian Cancer. The best test for further exploration is a CT scan.
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