CT v. Ultrasound / Facts v. Opinions

[Samiams]

After an automobile accident in Feb. 2005, I developed severe bruising on my abdomen. The following month I missed my period. At first I missed one or two, then I skipped over three & four. I also began gaining a lot of weight without any significant change to my diet or exercise routine. In Jan. 06, I felt a lump on the right side of my pelvis. It started of small but has grown in size. It now feels like two connected lumps. I also developed abdominal pain. Most days I feel like I have a bag of rocks on either side of my pelvis. Pain was so bad one day, I went to the ER. A CT of my abdomen & pelvis suspected small cysts within the region of the left adnexa region. I went in for my pap smear & was told to have a pelvic ultrasound. The report: endometrial stripe measures 1 centimeter. Measurements: L.Ovary 2.1x2.0x1.5 cm, R.Ovary 2.4x1.8x2.4 cm & Uterus 6.9x2.9x3.9 cm. Negative study. My GYN mentioned my uterus was tiny & that the ultrasound was much more reliable than the CT scan. She mentioned the masses were probably fat. Last month I got my period, after three months without. It lasted 25 days. It was considerable heavy & I passed a lot of large clots. Other symptoms include: hot flashes, spotting, back pain, fatigue, hair loss, frequent urination & swelling.

Why are my ovaries two different sizes? What does the size of my uterus indicate? Are CT scans really unreliable? If I have all of these symptoms & can feel masses, is it possible one of these tests is incorrect or was read incorrectly? Can fat really be the cause of all this? Does my accident play a role?

[bobbie1958]

A related discussion, CT versus US for Ovaian Cyst was started.

[maddompees]

i too have syptoms like these plus more i have had tons of tests, u/s , blood work ,colonoscopy, a bladder scope all clear althgough i have blood in my urine , low iron levels, pain in lower left side for over a year and trouble passing bowlmovements   no idea why ?

[remember1]

I called my Doc and got a referral to see an Gyn/onc. Thank you all for your helpful advice. This is why is site is so great! We can help other people make better decisions and be there for support. Also knowing that all the prayers matter too. I will report back after doc appt.   Thanks!  Karen

[scoutshadow]

I agree with orangefuzzball, you cannot rely on scans alone and pressing for a gyn/onc referral is the best option.  

I had an abdominal and CT scan and both showed a complex ovarain mass.  In fact the operation showed that the mass was pedunculated and arising from an old scar and attached to the bladder.

[orangefuzzball]

I had 2 internal/external u/s's, both identified a large cyst and eventually what was thought to be the left ovary. Initially thought to be suspicious, then 'definitely' benign. CT showed suspicious changes all over abdomen, including suspicions regarding cyst. Combined with physical exam and other tests doctors all said I was showing signs of ovca, but a fair few of the signs were atypical. I'm still awaiting confirmation of histology, but it certainly looks like I've got an extremely rare type of appendix cancer called Pseudomyxoma (PMP)which often first appears to be ovca in women before surgery. Although the u/s showed up an unaffected left ovary it was actually joined to the cyst. Physically although I had a 24cm x 8cm x 16cm cyst I experienced very few symptoms, bloating, a huge stomach and feeling pressure.

It's pretty unreliable to rely on the scans in isolation, and nothing can be certain until after surgery. Push for a gyn/onc refferal just to be on the safe side.

Good luck
Lisa.

[sk2006a]

it's common not to be able to see ovaries past menopause.  they shrink, supposedly to the size of a raisin, after that point.  i've been told several times that's it's actually good when they can't see your ovaries.  i'm in the same boat.  i keep thinking i would like SOMEONE to be able to see them and tell me they're ok for sure :)

[aligator79]

I had both a pelvic US and V U/S.  They could not see my ovaries on either one.  They did see a shadow about 2x4 cm.  My dr then sent me in for a CT scan which showed a softball sized dermoid cyst.

[Samiams]

What other symptoms did you have? How have you been doing since your surgery?

I am not very impressed with the attitude my GYN has about this. I have a long list of symptoms and the "fat cluster" theory only accounted for a few of them. The rest she simply said she didn't know what the cause was.

If I were the doctor in this situation I would look at factors like the differing test results, the symptoms and the family history. Based on those factors I would rather be safe than sorry and recommend the patient see a gyn/onc.

A common theme throughout all the literature I have read on gynecological cancers is that it repeatedly goes undetected until Stage 3. Well docs, perhaps some of you are not listening to your patients or asking open ended questions. How many of these patients presented with signs that may have led to an early diagnosis? How many patients were told to simply

[remember1]

Has anyone had a v/ultrasound and the report said "We could not identify either right or left ovary.  I don't understand that. I still have my ovaries, had my uterus removed, but not the ovaries.  I am 59 so maybe they have shrunk up and gone away. I guess it is good they didn't find any masses. Karen

[Samiams]

By the way, I appreciate all your comments. It really helps to connect to other people who have been down this road & know what to ask! Thanks :)

[Samiams]

To answer some of your questions:

I had both an ab. & a transvag ultrasound. These results came back negative.

I also had a CT Scan which showed cysts in my left adnexal area.

I also can feel lumps on the right side of my pelvis.

[sk2006a]

CT scan for the abdomen is good, but not always as good for the pelvis.  The pelvis is just more difficult to see.  Was your pelvic US vaginal?  Transvaginal US is considered superior to transabdominal/pelvis for visualizing ovaries because the "wand" actually gets closer to the ovaries.  Second opinions are never a bad option, if only for reassurance!  Best wishes..:) Susan

[Gatsby]

Hi and welcome.  I would suggest that you get a 2nd opinion with a gyn/onc.  They are specialists and have seen it all.  Although 99% of ovarian cysts, masses & tumors are benign, you would be wise to seek the 2nd opinion given your health history.  You are in my thoughts and prayers.  Godspeed
~Tascha

[xrayu2]

Ovaries are typically the size of walnuts and vary in size much like everything else in our body does.  Some women's breast are larger than the other.  Typically they say u/s is the best for examining the pelvic organs because of the ability to distinguish fluid from solid so much easier.  Was your CT normal also?  Could you be experiencing some sort of blood clot or hematoma(large blood collection from bruising) that is not dissolving?

[Tybear]

I'm not sure about the difference between the two, but when I was initially diagnosed with "tumors" in my abdominal region, it was the CT scan, not the ultrasound that saw them. Infact, my ultrasound report said my ovaries looked normal, but my left kidney seemed swollen. They suspected kidney stones, and that is why they ordered a CT scan, which then showed several masses spread throughout my pelvis and abdomen. Your symptoms hit home with me, because I had urinary frequency quite badly but it was my hair falling out that really bothered me. I was 26yrs old, no family history of any cancers and was diagnosed (through surgery) with stage 3c Ovarian Cancer. Now of course I'm not suggesting that you have cancer, but don't let Dr's convince you that you are too young. I have one child and was on birth control pills for almost 10yrs - it can happen. I agree with Tascha in that you should seek out an opinion from a gyne/onc, or atleast get a second opinion. Good luck.
Becky

[Samiams]

I wanted to include more info but the form wouldn't let me. Please note I am 28 years old & have no children. I have a family history of various cancers (including brain cancer) and heart disease. Since age 11, my periods have always been regular. I have not taken birth control in over 3 years.