complex ovarian mass

Hi,
am 27weeks pregnant and had my 3rd routing ultra sound. During the first 2 ultrasound scans 2 fibroids (leiyomas) were detected, one on the lower part of the uterus measuring about 5x5cm and one at the upper part, almost 15cm.
Now I have done another scan at 27 weeks and the report reads " a well circumscribed hypoechoic mass measuring 42x42x15mm and a huge well circumscribed cystic mass with dimensions greater than 140x169x107mm seen superioir to the gravid uterus. It has thick internal septae and some echogenic solid components. the cystic portion has few internal echoes. There are no ascites.
I am wondering how come there is no mention of the second large fibroid that was seen on the scan at 11weeks. Could this be the same mass that is now appearing as a possible ovarian mass? Also would this kind of mass be likely benign or malignant?

thanks
ibi

[Annekathryn Goodman, M.D.]

Dear Ibi
Hello to Nigeria from Boston!

You have two significant fibroids in your uterus. Fibroids are benign muscle tumors that are very sensitive to female hormones. hat is they grow with estrogen stimulation.  In pregnancy it is not uncommon for fibroids to get extremely large and painful.

just reviewing the reports:
first 2 ultrasounds :5 cm and a 15 cm fibroid
27 week ultrasound:  4.2 cm by 4.2 cm  and a second 14 by 16 by 10 cm mass

I would guess that they are the same fibroids seen earlier that have undergone change from the forces of pregnancy.

It is tricky in pregnancy to decide how far one wants to take an evaluation. Your baby is still too small to be born.  Your choices are repeat ultrasounds monthly. Another test that can help sort out the location of the mass  (ovarian versus uterine) is an MRI . MRIs are safe in pregnancy. Ask your doctor what they think.

The best plan would be to wait until after your baby is born to sort this out.
please let us know how you are doing
best wishes