My granddaughter recently had severe abdominal pains that brought her into the ER two times. Today the doctor called to say there seems to be something on her uterus, and said it could be a calcium fiber cyst. What is this? How is it treated? Can you give us any other information?

--Phyllis

Most likely what your granddaughter has is a "fibroid." This is a benign growth of the muscle of the uterus and is very common, affecting about 40 percent of women. Fibroids may enlarge the uterus and cause heavier menstrual flow with more cramping and pain. Sometimes a fibroid grows on a stalk off the uterus (kind of like a mushroom); if it twists on the stalk, pain can be severe. Sometimes a fibroid gets bigger than its blood supply can handle, and the middle part dies off -- this can be painful as well. Sometimes the fibroids calcify (develop mineral deposits); usually calcified fibroids don't cause much pain.

If a fibroid is pedunculated (on a stalk) and is causing pain, it can be removed. Often this can be done through a laparoscope by "lassoing" the stalk with a loop of suture and then cutting the fibroid in small pieces to remove it through tiny incisions in the abdomen. (This is one of my favorite surgeries to do.) Sometimes fibroids within the uterine wall are removed through incision like that used for a cesarean section. Sometimes fibroids can be shrunk by use of medications. Sometimes we do a hysterectomy. And sometimes we just wait and see what happens. The treatment depends on the severity of your granddaughter's symptoms and her desires.

Another possibility is that her uterus is fine and she has a cyst on an ovary. Ovarian cysts, especially if large, can cause severe pain, usually on just that side. A certain type of ovarian cyst called a "dermoid" often has calcium in it; dermoids are very interesting because they can contain fat, hair and even teeth! An ultrasound should be able to distinguish between something going on with the ovary or something with the uterus. Many times, an ovarian cyst will go away by itself, but if it is very large or if pain is severe, a laparoscopy is done to remove it.

Your granddaughter should follow up with her gynecologist. Evaluating and treating uterine and ovarian problems are exactly what we gynecologists do best.