Fibroid and pelvic mass

[mps58]

I am concerned about these U/S findings:

There is a clinical history of uterine enlargement. No prior studies for review.

FINDINGS:  Using the patient’s urinary bladder as an acoustic window the uterus is enlarged, measuring 17 x 9 x 9.5 centimeters. The left ovary was not seen by transabdominal technique. The bulbous nature of the uterus is better evaluated with transvaginal technique, but the configuration suggests a large uterine fundal fibroid.

Following voluntary urination, endovaginal imagery was performed and reveals a double wall endometrial width of 9 millimeters. This may indicate the proliferative phase of the menstrual cycle. By this modality, a large septated fluid collection lies in the right adnexa and whether this is a septated ovarian cyst versus hydrosalpinx is ambiguous, and further evaluation may require direct inspection. Best estimation of the septated, complex, cystic mass is 8.5 x 4.2 x 10.1 centimeters. The left ovary was poorly seen, secondary to the uterine fibroid. Best estimation of the left ovarian size is approximately 3.6 x 1.8 centimeters. Long axis could not be determined due to inability to visualize within that plane. No free fluid seen in the cul de sac. The previously described uterine fibroid as seen by transabdominal technique, by transvaginal study measures 7.0 x 6.7 x 7.0 centimeters and lies in the uterine fundus.

IMPRESSION:
Cystic mass in the right adnexa for which further evaluation may prove warranted with direct inspection. Dr. XXX notified of these findings and concerns by phone at the time the study was interpreted.

SPECIAL ATTENTION

I have also had a CA 125 test which came back normal at 4.9.  Would it be likely that surgery will be recommended?
Thanks!
mps

[Annekathryn Goodman, M.D.]

Hi There,
thank you for your complete information. I would agree that you should consider a surgery to remove that right ovarian mass. It is not possible to make a diagnosis without evaluation under the microscope. most cystic growths and masses are benign. However there is a small risk it could be malignant.
It is possible that the mass is just a blocked tube with fluid within it. But I would still recommend surgical removal
best wishes

[mps58]

I'd like to include some additional information about myself.  I am 49 yrs old, premenopausal and have no children. No immediate family history of ovarian cancer, however my mom was adopted and I have no maternal medical history.  My only symptoms are heavy bleeding during my periods for about 6-8 months now, and distention of my abdomen in the past couple of months.  I am not experiencing any pain other that some slight cramping on my first day of heavy bleeding.

My mom (who is 79) is battling her third cancer in 2 years.  Her first cancer was in April of 06 and was bladder cancer that was removed and has not recurred.  In Oct of 06, shehad a modified radical mastectomy of the left breast.  In January this year, she was diagnosed with a precancerous lesions of the vulvar.  We have been told that these cancers are not related to one another.

I appreciate any insight you may have on my previously posted ultrasound report.

Thank you for taking the time to post to this helpful site!
mps

[mps58]

Thank you so much for your response.  I have seen several posts that suggest that if there is any possibility that a cyst might be cancerous that a gynecological oncologist be used.  Would you recommend one for me or would a gynecologist who performs surgery be fine?
Once again, thank you!
mps

[silver&gold]

Hi ,
its best to make sure there will be an oncologist available to assist with surgery if any cancer is found . Most cysts are benign around 95% but you have just one chance to get it right,  if any cancer is seen during surgery an oncologist has  around 3 years extra training.
  
Best wishes Angie

[mps58]

Thanks for your reply Angie.  I spoke with my gyn today and she has been in touch with the gyn-onc department at our regional Medical Center.  They have a team of gynecologists and gynecologic oncologists that work together on these types of cases.  They have agreed that this cyst needs to be removed and my gyn is referring me to them to perform the surgery.  She thinks it should be a couple of weeks before I have an appointment with them.

I already feel much more at ease knowing that I will be going to a specialist - just in case.

Thanks once again,
Maureen

[silver&gold]

Hi Maureen,
thats good that you are being refered to the gyn oncology team , I hope everything goes well at your appointment and that pathology from your surgery is benign.

Best wishes Angie