Fallopian Tube Cancer

[ann51]

I was diagnosed 2 years ago with Fallopian tube cancer at the age of 48. I had a complete hysterectomy (removal of uterus, fallopian tubes, and both ovaries. Then 6 rounds of chemo. After chemo, I had a CT scan. The CT scan showed a 2 cm size soft tissue structure behind the bladder. A follow CT scan 6 weeks later showed the same thing. Both scan reports said  that it could be the right ovary. My pathology report said that both ovaries had been removed. An ultrasound said it was an "apparent right ovary" and named the resistive blood flow index. A follow-up ultrasound several weeks later showed the same thing.I was 49 at the time of these scans. I had several second opinions, all of which said that it was probably a ball of tissue and not cancer. At 50, I had a CT scan. The report said that "no ovary could be seen". Recently, I requested a transvaginal ultrasound.(5 months after most recent CT scan) I am now 51. The report said that there was a 1cm x 3cm ovoid structure with venous blood flow in the same place as previous ultrasounds. The doctor assured me that it was not cancer. He also stated that it was not the cause of my episodic fatigue, muscle ache, sleep disturbance, frequent urination during these episodes. I still wonder if this is an ovary. Does scar tissue have venous blood flow? I feel that many of my current symptoms are hormonal. I am taking 1.25 premarin and still have occasional hot flashes. My symptoms are cyclic in nature, occuring about every 3 to 4 months.I am not sure what to do or where to go from here. Thank you,

Ann51

[ann51]

Thank you for your reply. I guess the possibility of the mass being an ovary bothers me because I am BRCA II positive and am at high risk of ovarian and breast cancer. I don't think I am worried about it being cancer because a recent ultrasound  showed the mass was smaller and doctors have assured me that it is not cancer. If I have a retained ovary and I am 51 years old, wouldn't the ovary be producing less estrogen at times/some months?  I guess I am wondering if my episodic symptoms are due to an ovary that is going through menopause? Thank you for your insights. I know I am babbling on, but I am trying to understand if it is possible that I would have hormonal imbalance 2 1/2 years after surgery while taking 1.25 premarin.

Ann51

[Fernando Roque, MD]

Hi,  I think it would be difficult to be certain what the nature of that mass is, unless a tissue sample was taken and examined. Your episodic symptoms may indeed be hormone related, but are probably due to a decreased level of estrogen.  If you have a retained ovary, and that ovary is still functioning, then you wouldn't be having these hormone-related symptoms at all.  

So what are your options?  If the mass really bothers you, you can ask your doctor to do a biopsy to settle the matter once and for all.  Alternatively (and this is what I would recommend), just have either a transvaginal ultrasound or a pelvic CT scan done after 4-6 months.  If the mass hasn't changed in size and appearance during that time interval, then it's probably something that you shouldn't be worried about.