Ultrasound Report and Pain

[PJ565]

I recently had a tran-vaginal ultrasound the results are as follows:
The uterus is 8.7x4.8x5cm. Somewhat generally heterogeneous uterine echotexture with not apparent focal mass. The endometrial stripe is 9mm.  Cervical nabothian cysts.

The right ovary is enlarged at 6.3x3.7x3.9 cm.  Within the right ovary is a hypoechoic 4.6x2.9x4.1 cm mass not consistent with a simple cyst. This could be an organizing hemorrhagic cyst but ovarian neoplasm cannot be excluded.  The left ovary is 3.3x1.8x1.6 cm.  Color Doppler imaging of the adnexa is within normal limits.

No cul-de-sac fluid

I recently switched to a new ob/gyn (that is who ordered the ultra sound). Last week I did a CA125 tests and still no phone call with results. I called there today.  The other thing is that they want to repeat the ultra sound the middle of next month.  IN the meantime I am having pelvic pain mostly on the right side and am having trouble getting the doctors office to return calls.  Is the approach this doctor is taking normal?  If it is not a simple cyst can it still go away on its own? Should I push to move up the ultrasound? Get a second opinion?  Any advice will be greatly appreciated.  

[Jazzeroo]

I was reading your story, and its similar to mine; I'm 33 years old.  Sept 1, '06 I had a 22 centimeter borderline tumor removed; no chemo needed. I was not told to have a hysterectomy in the future, but I do know that I may need one someday. My tumor was a grade 1 and is a high-grade carcinoma and the cancer cells multiply fast. I don't have the pathology report in from of me, but that is the gist of it.

The same as with you, the doctor removed my left ovary. Since then my right ovary has kicked in and functions normally. Good luck on beginning a new family. Thank you for sharing your story. You also mentioned that the CA 125 is not a precise marker for ovarian cancer, and that reassured me that my doctor was using a reasonable standard of care to not give me that test after my laparotomy.

Thanks to this website, though, I was able to read of a place where you can order a test like that online and then go to the physical sites that they have located all over the US for only like $99 or so. If I feel the need to get that test, I will check it out. I am in good health, and I'm glad to read you are doing well. Take care. Good luck in starting a new family.

                                                                      Lisa

[rmarie]

Since the report puts a question of ovarian ca in there, you NEED a GYN/ONC, so yes get a second opinion with one.  If it is cancer they give you the best chance with OVCA, I would switch because they are not returning my phone calls.

[lucky1977]

It's definitely not a dumb question....I have to say that I'm not entirely sure...but I know they started to use that word with me once they were sure that it wasn't just a simply cyst (i.e. fluid-filled cyst)....I believe that if they knew exactly what it was they would be more specific.  According to the dictionary,an ovarian mass is "A lump in tissue near the uterus, usually in the ovary or fallopian tube. Adnexal masses include ovarian cysts, ectopic (tubal) pregnancies, and benign (noncancerous) or malignant (cancerous) tumors.

Mine was an adnexal mass.  I notice in yours they use the word "hemorrhagic cyst"....At one point they thought that I also had one of these....it usually means a simple cyst that didn't burst and then started to fill up with blood.

Hope this helps you....

[PJ565]

yes yours answer helped make things a little clearer.  I am glad that yours was caught so early on.  I will in deed be more proactive in getting this taken care of as it does not look like the doctor will be.

[PJ565]

Thank you so much for your response.  I have been having problems for several months, horrible cramps, extremely heavy periods and clotting, pain during intercourse and abdominal pains off and on.  I had a gastroinstestinal consult and ultra sounds of everything except the ovaries, uterus, etc.  I have also had frequent UTI's which I guess now can be a problem with and ovarian mass.

I have another question and it may be a dumb one.  Does the word mass mean solid? as in not simply fluid filled?  

[PJ565]

Hi rmarie,

It is my ob/gyn that I am having trouble with.  My first appt. there was 4/24 for my annual. The appt. was with the nurse practitionor and in the discussion of some symptoms I had been having she decided the ultasound was needed.  They let me know there was an ovarian mass but then she said the doctor himself needed to review my file. Days went by and no info from the doctor (I called almost every day) finally I was having horrendous cramping and pushed the issue.  The nurse practitionor called me back and said the doctor still had not reviewed my file but she ordered a CA125 blood test (which I took 5/18 and still no call about that) and she ordered a follow up ultrasound.  The horrible cramps are pretty part of life for me lately before my period, but now I am still having pain and the last couple of days it is sharp and stabbing at times.  The wait and see approach on this makes me very leary.  I am sick and tired of being sick and tired.  I left messages today asking for the results of my CA125 and saying I am having sharp stabbing pains.  If they do not return my call today then I will call me general practitioner at home tonight (she is a friend) and ask her to write a referral for a second opinion.  
I am scared.  I am glad I found this forum as it has been helpful and it is nice to find people that understand these things.      

[rmarie]

Make sure the referral is to  a GYN/ONC and call the other office and tell them you are picking up your records.  That will get them tap dancing on your side.  good luck, keep us posted

[lucky1977]

I totally agree with the suggestion re: an OB/GYN tha t specializes in oncology.  Now that my tumour was confirmed as malignant they are referring me for follow-up with an oncologist.  

In terms of your CA-125, I don't know why but this blood work takes a long time to get back.  Mine was taken at a visit to the ER in the first week of May, and they still didn't have the results when my surgery took place on May 15th.  Remember, don't be too worried about the results unless they are into the thousands.  My gyn told me that they tend to increase a little when you have a cyst or some other type of inflammatory issue.  

Take care, and keep us posted.
Kelly

[lucky1977]

I hope my answer helps you somewhat.  

First of all, I would definitely encourage you to proceed with the next ultrasound...a month wait is not crazy, but of course the earlier the better.  The may wish to do it in the middle of the month as this is when we are ovulating and simple fluid-filled cysts are often present then.  Also, if the first was done at this time then they may want to have it at the same time for comparison purposes.

Secondly, I would ask for an MRI.  I had a solid mass show up on my transvaginal ultrasound in March, but my doctor was not that worried.  It was the MRI that showed that it was a neoplasm with malignant characteristics.

And no, based on the info I have received, most other masses, etc do not disapear on their own...they need to be surgically removed.  My mass was around 5x3x4 also...and the recommended taking it out...unfortunately the only 100% confident diagnosis is a pathology report, so it has to come out.

I just had the tumour removed on the 15th...unfortunately it was a borderline tumour (i.e. cancer), but luckily they think that they caught it early.  Time is of the essence...do not sit back and let them wait.....my gyno said that if I had waited 6 months, it could have been a very different story.