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Please help, MRI suspect I have ovary cancer!!!
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Please help, MRI suspect I have ovary cancer!!!

April, I had weigh loss, pale, tired even after shower. abdominal pain
Blood test indicated very low iron level. April 30 did ultrasound of pelvic a week before period
pap test and biopsy for endometrium negative.

May inserted Mirena IUD
- blood spotting almost every day after insertion until Aug 16
- then period from Aug 31 - Sep 14 (15 days)
- another period from Sep 22 till now still (20 days so far).

Aug 1, I had DVT on left up arm and shoulder.
Aug 9 another ultrasound of pelvic when I was in the middle of period
Sep 14 another ultrasound of pelvic when it's last day of period
Oct 1 MRI of pelvic in the middle of period.

April 30:
Right ovary is again enlarged now measuring 5.76 x 4.83 x 3.21 cm, with volume now 46.69 cc (previously 19.75 cc
(May 25, 2010) ) and shows two hemorrhagic cysts measuring 2.56 x 1.98 and 0.77 cm each along with a 2.33 x 1.5cm simple follicular cyst.
Left ovary is also enlarged measuring 4.61 x 4.13 x 2.8 cm (volume 27.90 cc) and shows a 2.75 x 1.8 cm simple cyst.small amount of free fluid is identified in posterior cul-de-sac
Benign nabothian cysts are again identified in the cervical aspect.

August 9 :
Right ovary is again enlarged now measuring 5.95 x 4.36 x 3.92 cm with volume 47.74 cc (previously 46.69 cc) and is now mostly occupied by a hypoechoic mass showing vascularity surrounded by few peripheral follicular cysts measuring 0.85 x 0.6cm.
Left ovary is also again enlarged now measuring 6.02 x 5.74 x 4.97 cm with volume 89.99 cc (previously 27.90 cc) and now shows two cysts measuring 4.4 x 2.79 and 3.2 x 2.02 cm each.
There is no free fluid in the posterior cul-de-sac.

A 2.13 x 1.8 cm hypoechoic, heterogeneous lesion identified in relation to superior wall of the uterus.

September US : I was told the hypoechoic mass in right ovary is not present. left ovary has 4 simple cysts and the volume is 102 cc

Oct 1 MRI:
The right ovary is enlarged containsing multiple peripheral follicles measuring up to 5.2 x 5.8 x 3.9 cm.
Arising from the left adnexa is a large heterogeneous partially cystic lesion measuring up to 8.6cm SAG x 8.3 cm AP x 4.6 cm TR.
It contains solid projections centrally separated by multiple cystic components. The left ovary as characterized by multiple small follicles is seen at the inferior aspect of teh lesion adjacent to the uterus, but is overall difficult to identify.
There is moderate amount of free fluid within the pelvis, Upon gadolinium administration, there is a enhancement of the solid projections centrally. The cystic component demonstrate rim enhancement.

There appear to be a right pelvic lymph node measuring 1.6 x1.4 x 1.6cm. Smaller left pelvic lymph nodes are seen with the largest mesauring up to a 2.0 x 0.5 x 1.0 cm.

There is a small amount of fluid associated with the right psoas muscle, which may represent bursitis.
why Sep 14th, they are still simple cysts, and Oct 1, they can be cancerous?
If this is cancer, based on the history, is it a late diagnose? what should I do next?
242604_tn?1328124825
Hi There,
thank you for your complete information. This must be very scary for you.
It is reassuring that your pap smear, endometrial biopsy, and CA 125 are normal.

It is possible that some of your symptoms are related to the IUD. IUDs can cause spotting, irregular bleeding, and infection in the fallopian tubes . Infection can cause swelling and pain of the ovary and fallopian tubes.

At your age of 44, it is very important for a full evaluation. I would recommend removing the IUD and having a full D&C, hysteroscopy to evaluate the lining of your uterus.
If the ovarian cysts persist through a menstrual cycle, then I would include a laparoscopy and surgical removal of the cuts.
please let us know what happens.
take care
4 Comments
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Avatar_f_tn
btw, my ca125 is 16.1
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Avatar_f_tn
Thank you very much for your reply. I saw a Gynecologic oncologist yesterday. She said the DVT (blood clot) is very rare position. One type of ovary cancer can cause this. And she also told me the MRI image looks very suspicious, I also did an abdominal ultrasound, there some lymph nodes found. She said my case is highly likely cancer.

She wanted me to do CT scan for whole body except head (the blood clot left an lump on my shoulder still), she suspected this might be enlarged lymph node.
So the scan can tell how the cancer is developed.
She is sending me to see specialist for DVT to evaluate if its safe to do surgery. I crashed when I walked out of the office yesterday.

Now I am preparing for either chemo or surgery. And thinking of how to give the bad news to my kid. But the same question still remains,why all the ultrasound results are fine, then 3 weeks later, it's cancer.  I wish I am not diagnosed too late so that I can have a chance to live as long as possible with my kid.

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Avatar_f_tn
pap smear, endometrial biopsy were done in May. CA125 was done last week.
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