Pelvic CT Results and concern

I have symptoms for six months or longer, mainly severe bloating and extremely tired. I am 42 and never had children.

A recent pelvic/abdominal CT scan with IV contrast on July 14 showed "The patient has a 4.7 x 4.1 cm right ovarian mass with fat and calcifications. Right dermoid should be considered. There is a left adnexal mass which may merely be a cyst. There are small retroperitoneal nodes. The patient also has bilateral kidney stones and a stone in the uterer causing marked left hydronephrosis."  My hgb is 8.8.  It should be 12-15 for women.  I have not been to a doctor in over ten years and do not know how long I have been anemic.

I had a TA/TV ultrasound done at a different hospital on June 20. Only finding was follicular cysts on both ovaries, which they said are considered normal.

What do the CT results mean and will the dermoid have to be removed?  What is the significance of the "small retroperitoneal nodes"?  Why did the CT show the dermoid and not the ultrasound a month before?  Anemia from the dermoid possible or from the retroperitoneal nodes or hydronephrosis?  

Thanks for any help you can provide.

[Annekathryn Goodman, M.D.]

Hi There,

While ultrasound is a great tool, like all x-rays, it is just a bunch of shadows. Sometimes bowel gas can be in the way and it is not possible to clearly see the ovaries. Since there is a discrepancy between the ultrasound and the CT scan, you should ask your doctor to go over those reports and films with the radiologist. It can be very helpful for a radiologist (a physician trained to evaluate x-rays) to get more of your story and go over the films with your doctor. I find that sometimes areas of the films get reinterpreted in light of the new information. Retroperitoneal lymph nodes are lymph nodes in the deep abdominal tissues. There can be mildly enlarged in any irritation or inflammation. They do not necessarily add information. They might be a bit enlarged because of what is going on in your kidney. Hydronephrosis means that your kidney is blocked. That can cause pain, fever, kidney infections, and if untreated can cause kidney damage. You need to see a urologist immediately for that.

As far as how you are feeling, that does not sound right. It sounds like you are in the process of being evaluated which is good!

You are anemic and that can be due to many things (heavy periods, poor diet, bleeding from your intestine, drugs.) That also needs to be sorted out some more. I am glad that you are seeing a doctor! Please keep me posted.

[River12]

I'm 17 years old. I went to see a new doctor last week, and something about my check up left me with a bad taste in my mouth. I didn't know much about Pap Smears, because I've never had one up until last week. I told the doctor I was a virgin. He still wanted me to have a Pap test done. since I missed two periods I agreed. He then asked me since I was a virgin did I want him to go up my scrotum. I felt like he was making a mockery of the whole thing. My question to you is this possible, or do I need to report this doctor and for what grounds?