Repeat Pelvic Ultrasound

39 yr old female, no children, in 2001 mother passed of ovarian cancer at age of 47
hx: gastric bypass, hernia repair
followup to pelvic ultrasound , original 8/10/2010, this one was just completed  on last Wed

transa
bdomonial/transvaginal
uterus measures 9.9x4.4x5.4---numerous small mymetrial lesions are seen most compatible to uterine fibroids
1.0x1.0x1.3cm anterior fibroid near fundus decrease since previous 1.8x1,4x2.0cm
1.8x1.5x2.0 cm fibroid near the lower uterine segment which appears to be measured, 2.1x1.7x2.0cm
1.1x1.3x1.2 fundal fibroid previously measured 1.2x0.9x1.1cm
1.1x0.8x2.7cm fibroid posterior lower uterine segment which previously measured 1.3x1.1x1.0cm



right ovary 2.5x1.1x2.7--left3.1x2.1x.2.9-----endometrial stripe 7mm-----

again seen is a complex lesion within the left ovary, on previous measures 1.9x1.8x1.8cm, on current exam, 1.9x1.3x1.6--------as noted there is some suggestion of nodularity along the wall, although this may represent some recurrent cough (what does this mean)    on color doppler imaging there is peripheral flow, but no definite flow seen centrally, there is no significant free fluid within the posterior cul de sac.--

PREVIOUSLY DESCRIBED COMPLEX LEFT OVARIAN LESION IS AGAIN NOTED AND IS LIKELY SOMEWHAT SMALLER SINCE PRIOR EXAMINATION, GIVEN ITS QUESTIONABLE COMPLEX APPEARANCE WITH NODULARITY, CONSIDER AN ADDITIONAL FOLLOWUP IN SEVERAL MONTHS TO CONFIRM RESOLUTION.  THIS LESION PERSISTS, MRI EXAM CAN BE CONSIDERED.

My concern is because of my family history,also i am a RN, working in acute care.  when my provider reviewed this with me, she said it was a cyst. i see the word lesion as being different than that, could you clarify. also what makes this a complex lesion?  i have begun to experience some discomfort in the past couple months, there has been a slight differnence in my cycle, in that i spot, and then two laters i'll start my period,  no other obvious changes.

[Elaine Brown, MD]

Hi!
I think there may be a transcription error in your report (recurrent cough), and I am glad that you are in health care so that you will be able to understand this!

IF you were my patient, I would suspect that the lesion or cyst in the left ovary is a hemorrhagic corpus luteum cyst that is taking awhile to resolve.  The fact that there is not increased doppler flow in the area, and the fact that it is shrinking BOTH suggest that it is benign and going to resolve.  I WOULD probably repeat the ultrasound again in 6-12 weeks due to your FH.

As you are aware, you also have multiple small fibroids.  Those might be causing the changes in your cycle.  Not necessary to do anything about them unless they become symptomatic, or grow rapidly.

Sorry about some technical terminology, by since you are an RN I figured you'd understand.

Good luck!
Dr B