Avatar universal

U/S not good, Very worried!

I'm awaiting test results to evaluate possible endometrial/cystadenocarcinoma. I'm to have a D&C next month because of heavy bleeding, and I am also anemic. My ca125 was negative, but my doctor wants me to have an MRI. Here is my U/S results:

The uterus measures 9.7 cm in length, 5.4 cm AP and 6.6 cm
transverse. The myometrium is mildly heterogeneous but no focal
lesions are seen

The endometrium contains internal fluid and debris, and is distended
to 20 mm. The endometrial lining is overall lobular, and polypoid or
mass lesion cannot be excluded.

The right ovary measures 5.7 cm x 6.9 cm x 5.5 cm on endovaginal
images. The right ovary is diffusely heterogeneous with multiple
small cystic regions and heterogeneous soft tissue. Infiltrating mass
lesion or lesions cannot be excluded. An arterial waveform is
demonstrated within the right ovary.

The left ovary measures 9.5 cm x 4.5 cm x 6.6 cm on endovaginal
images. The left ovary is also diffusely heterogeneous with at least
2 larger complex cystic components (each probably 5 cm in diameter)
with an intervening thick internal septation and additional
surrounding soft tissue. An arterial waveform is demonstrated in the
left ovary.

There is no free fluid.

Fluid and debris in the endometrium with a lobular appearing
endometrium, cannot exclude polypoid or mass lesion such as
endometrial carcinoma. Bilateral complex ovarian cystic masses,
larger than on the prior examination in 2008. While these may
represent gradually enlarging bilateral complex cystadenomas,
cystadenocarcinoma of the ovaries cannot be excluded. GYN/ GYN
Oncology referral is recommended.

So,can someone explain to me what all of this means? I am currently seeing a OB/GYN. But, maybe I should get a second opinion by a GYN/ONC?
9 Responses
667078 tn?1316000935
Unfortunately they may not know what it is until they look with surgery. I would go to a GYN Oncologist not because I think it is Cancer but because they deal with complex cases GYNs do not.

Avatar universal
Yeah, that's the hard part. I wish I knew already so I could not worry during the holidays. :(
667078 tn?1316000935
I know it is hard to worry. With me they were sure it was cancer I was in surgery in less than a week. I have had three cancer scares which turned out to be benign. Two of the times I had to have surgery to figure out it was not cancer.

Avatar universal
Wow, sorry you have been thru so much, Alex. I hope you're doing better now. But these doctors don't tell you what impression they get or the likelyhood of it being cancer. I'd even like a ballpark figure of some kind. lol
Avatar universal
You did not mention if you have any risk factors for ovarian or endometrial cancer. If you do not then there is a very good chance that you do not have cancer.

I had a 9.5cm ovarian cystadenoma (u/s report similar to yours). It was benign. However, I was grossly overtreated. My surgeon waited for the results of the frozen section of my ovary while I was in the operating room under anesthesia. Although it came back benign, he proceeded to remove the rest of my sex organs - my other ovary, uterus, and tubes. I have been suffering the many adverse effects ever since. That was 8 years ago.

I wish I had done things VERY differently - the first being to understand the hysterectomy industry and gross overuse of female organ removal. I wish I had not trusted my surgeon and sought out another surgeon ON MY OWN. I wish I had altered the surgical consent form to specify what could and could not be removed and under what circumstances. Since I did not have cancer, all that should have been removed was the cyst (cystectomy). All my parts should have been left in place when that frozen section came back benign if I had a surgeon who had good cystectomy skills and did not remove organs unnecessarily.

Your report said that the endometrial lining is 20mm and "the endometrial lining is overall lobular, and polypoid or mass lesion cannot be excluded." Polyps and fibroids can be difficult to differentiate from the lining itself making it appear thicker than it is. Polyps and fibroids are almost always benign. However, they can cause heavy bleeding. Polyps are easily "snipped off" which should stop heavy bleeding if removed at the stalk. But fibroids especially if submucosal can also cause heavy bleeding. There are non-hormonal and hormonal meds to treat heavy bleeding. Or the fibroids can be removed via hysteroscopy or myomectomy allowing you to keep your uterus and its anatomical, skeletal, hormonal/endocrine, and sexual functions.

Please research the lifelong functions of the female organs and the gross overuse of hysterectomy and oophorectomy if surgery is being recommended since you are the one who will suffer the consequences. And make sure your desires are clearly stated on the surgical consent form with your doctor signing off on any revisions you make.
Avatar universal
This was so helpful! You really opened my eyes to many things here. I just wanted the report explained. I really appreciate the time you took to do this.

hugs :)

I have also postponed my surgery and am going to get a second opinion.
667078 tn?1316000935
A second opinion is good. I did not get one and I wish I had. I did not have a good feeling about my surgeon. I never saw him again after surgery. I was left with only a nurse until I changed hospitals.


Avatar universal
A second opinion is a good idea. Unfortunately, with the prevalence of unnecessary female organ removal, a number of opinions may be needed. I have read that it is good to seek other opinions from doctors affiliated with different groups and even different hospitals, if possible. Also, be wary of teaching hospitals. I thought teaching hospitals were affiliated with universities but many are not. My surgery took place in a teaching hospital which I did not realize until I was in pre-op and they had already started sedation. Gynecology residents are required to do a minimum number of each method of hysterectomies. Had I known this, it would have been a red flag for me.  

Best of luck to you in navigating the medical maze! If you have more questions, do not hesitate to ask and I will attempt to answer them.
Avatar universal
Well, My pap and HPV test came back normal. But I do know that has little to do with the uterus/endo/ovarian cancer possibilities. I don't know anyone really in my family with this type of cancer. I have a few aunts with breast cancer.  I am so nervous because I was working hard to get my iron back up from 6.8 hemoglobin -  four weeks ago. I had it to 7.9, and mother nature decided to bring me her gifts yesterday and heavy bleeding began again. My doc gave me provera but I am afraid to take it in fear it might make the bleeding even worse. I wish the GYN/ONC was sooner but it's a week away. :(
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