When to get 2nd opinion

[dlt5857]

I recently had an MRI of the Pelvis (was considering having a UFE performed). I have a Fibroid on my right which measures8.3x8.2x7.5 cm., also in the right ovary was a lesion "incompletely characterized, it is uncertain if it is porteinaceous cyst. Can't exclude fat containing lesion or endometioma."  The size of the lesion is 3.7x2.5x3.4 cm. No free fluid in pelvis. In 2005 I had polyps removed my uterus, March 08 I had a flat polyp removed from my colon.
The IR who read the MRI told me it was a complex cyst and to get it looked at by US as soon as possible. However when I went to my GYN she was basically non-concerned. I'm 51 and premeno, so she is telling me it is hormonal. I will have a TV US to check blood flow this week.
My symptoms have me really wondering.   Since  the end of June I have gained 15 pounds, gained 4 inches in waist and 3 inches around hips. I  also have Hasi/Hypo disease and also struggling with weight but never like this!  My uterus has increased in size, I'm bloated after eating, and have indegestion in other words just plain miserable. I'm not used to feeling like this and want to get back to my life.  I don't know what to do, if I should seek another opinion. If there is a chance of Ovarian Cancer, I don't want to wait till it's too late..
Thank you in advance, I hope I made some sense..
Donna

[Annekathryn Goodman, M.D.]

Dear Donna,

I do not think your weight change is a gyn issue.  It may be related to your thyroid disease. It can also be related to aging (you are now 51 years old?)

Bloating can definitely be due to a large fibroid which is pushing the bowel out of the way.

Your choices for intervention include:

old fashioned hysterectomy with possibly removal of one or both ovaries
-surgery just to remove the fibroid (myomectomy)
-uterine artery embolization (UAE) (I assume that is what UFE means?) which is the plug up the blood vessels that nourish the fibroid . When it loses its blood supply, it dies and then shrinks.

UAE does not always work. There is a period of time that can last up to 6 months where you have pain from the procedure.  Rarely , women can get an infected fibroid that requires a hysterectomy to treat.

Could you have a cancer? Yes - it is a rare possibilty. If you have a rapidly growing fibroid (like it is doubling in size in a 6 -12 month period) or a growing complex ovarian cyst, that may be a reason to choose surgery over UAE.
best wishes

[Annekathryn Goodman, M.D.]

Dear Donna
if your fibroid is growing, that can increase your waist size.
good luck with sorting out what is the right intervention for your.
best wishes

[dlt5857]

Thank you  (Update)
, I just got the preliminary report and the right ovarian complex lesion has shrunk!, Now the left ovary is enlarged but just a simple follicular cyst. However the fibroid has enlarged went from 8.3 cm to 9.3 cm and the uterus is enlarged 13.6 x 6.5 x 8 cm. ( how  many weeks is that, I feel huge )  In 2005  the uterus was 8.8 . I still have indigestion and bloat and the weight gain., but must now be from the fibroid . I spoke to the IR about the UAE procedure and he feels I'm not a candidate due to size.. Says it would only shrink maybe 10% . I wish Menopause would get here already  As far as my Thyroid is I've never gained this much weight so quickly, usually I get it somewhat under control, though it is a struggle. I've gained 4 inches in my waist since end of June. Could that be from my Uterus enlarging. Again thanks for your help, I see my GP tonight. My Gyn doesn't want to see me now till Feb for pap.