I'm a newbie in this forum, but a returning "princess" (having received lots of wonderful information and support from Hystersisters in 2001 when I had a SAH for multiple large fibroids and anemia). Two weeks ago, I developed sudden abdominal discomfort that didn't go away. Some of the pain radiated to my cervical area and felt like menstrual cramps. I followed up with my gynecologist three days later when things still felt uncomfortable. The pelvic exam was painful -- a first, for me -- and she suggested an ultrasound. I had abdominal and transvaginal ultrasounds done, which showed a "complex mass" measuring 4.8 cm x 3.2 cm x 3.0 cm on the left ovary. (Right ovary appeared normal and was about half that size) I am scheduled to have a pelvic and abdominal CT scan tomorrow and already have the name of a gynecological oncologist for a consultation. My CA125 and CEA19-9 levels are in the normal range, however I know that this in itself is not a guarantee that the mass isn't malignant. Has anyone with ovarian cancer or a complex ovarian cyst had an MRI as an initial diagnostic scan rather than CT? I do have some concerns about the radiation used with CT, plus the barium and IV contrast (neither of which I've had before). I have had multiple MRIs with gadolinium contrast for another medical problem (brain tumor), so perhaps that's why I feel more comfortable thinking in those terms. Any suggestions about diagnostic testing, consultations, reading list, or other comments would be welcome! Obviously, I don't want to go through major abdominal surgery again without a good reason to do so. Have any of you had a needle biopsy for an ovarian mass? I am hoping that there will be enough diagnostic information from the scans and exams to be able to avoid surgery if possible. Also, for those of you who have had an ovary removed for either cancer or a large, complex cyst, did anyone retain their other ovary? I cannot use hormones due to my medical history and would like to keep a healthy ovary if at all possible.
Thanks in advance for any replies!
age 52, SAH 6-18-01 for multiple large fibroids and anemia, much better quality of life since that surgery! Now concerned about recently discovered growth on left ovary.
Sorry you are going thru this but glad that you have come to us.
When first suspected, I had an abdominal and pelvic cat scan, not an MRI.
I stuff you have you have to drink is really not that terrible. I may be nuts but the taste was banana and it was like a thickshake. Just make sure that it is very cold.
In my case I was told not to have the contrast IV because I also have asthma and they were not sure whether or not I would be allergic to the dye. The technician who gave me my first cat scan told me that and since then I just had the cat scan without contrast. My oncologist was ok with that and there was no problem.
Good luck to you and let us know how your test results come out.
Originally posted by nancy52 I do have some concerns about the radiation used with CT, plus the barium and IV contrast (neither of which I've had before). I have had multiple MRIs with gadolinium contrast for another medical problem (brain tumor), so perhaps that's why I feel more comfortable thinking in those terms. Any suggestions about diagnostic testing, consultations, reading list, or other comments would be welcome!
I have had several CT scans and have not had any problems, I would get a little diahrrea from the contrast (not sure if it is the one you drink or the IV) but other than that it is rather painless and uneventful. (the IV I know souldn't be taken if you have certain allegeries or if you have asthma not sure on the last one)
I am not sure which is the better in diagnosising ovarian tumors, or any tumors for that matter. I do know that MRI cost more than the CT scans and some insurances will not pay for an MRI unless it is deemed necessary.
I would talk it over with your doctor (and your insurance company if possible) and see what you can find out.
Best of Luck and will pray that it is nothing to worry about
Most gyn oncs will not do a needle biopsy for an ovarian mass.
They insist upon complete removal.
If the mass is benign, your other ovary will remain.
I am not sure of your age, but alot of us here were thrust into surgical menopause in our 40's with no HRT, and have done very well.
I too have had quite a few CT scans with no problem.
Hopefully this mass will turn out to be benign.
I think there is minimal radiation used now vs. years ago--they are careful to scan only what's needed and it's a fast procedure. If you are allergic to iodine or shellfish, let them know, because that may mean no IV contrast. The barium isn't too bad, just boring to drink. It will give some some mild diarrhea but nothing like with the flu or food poisoning. I'm glad you're going to a gyn/onc for this. Follow his or her advice for the next steps.
I know how you feel I also have a large complex mass(17*8.5*9 cm)My doctor gave me a ultrasound and she also ordered a blood test called CA-125. They are giving me a laparotomy on 8-3-04 and will extract the mass and the ovary conected to it. She told me that they will try not to do a hysterectomy but if need be they will. So that is what is happening to me and with you they may decide to go a different route.I know your pain and I hope you feel better and get your questions answered.
I am so sorry Nancy that you are having to go thru all of this!! 's to you!!
I had a catscan, too, when the abdominal pain started and found that I had a tumor. I am 8 days post hyster and little did we know but they found 2 tumors behind my uterus. Now we are waiting to hear if they are malignant or not.
I agree, trust your doctor, but only if you are seeing a gyn oncologist. They are the experts with all gyn cancers, but it is particularly important when dealing with a possible ovarian cancer.
If your ca 125 is elevated, and your cyst is described as complex, the very best thing you could do is to consult with a gyn oncologist.
Only a gyn oncologist is qualified to perform the necessary surgery for ovarian cancer. NOT an ob/gyn!!!!
Here is a link to a Johns Hopkins web site that you should read.
Scroll down the center of this link and for the area titled the Two Biggest Decisions to Make when facing possible ovarian cancer.
Thank you SO much for the encouraging messages, practical suggestions and other information in the replies to my original post. As things turned out, I wound up having 2 CT scans today, since the initial two containers of barium (from last night and early this morning) had not yet traveled far enough into my intestines to give good contrast in the pelvic area by the time of my initial scan. They did the abdominal scan, then gave me two more containers of barium to drink, and asked me to return for a second scan a couple of hours later.
Meanwhile, after the first scan, the radiologist -- who was absolutely wonderful -- responded to my request to see the images by bringing me into his office and reviewing not only the CT films, but those from my sonograms last week (abdominal and transvaginal). From the comparative images, he was able to suggest that what had appeared to be a complex ovarian mass was likely to be a misplaced loop of bowel, adjacent to the cervical stump (which remains following a supracervical hysterectomy in 2001). We talked again briefly after the second CT scan. He mentioned that the contrast still hadn't moved as far into the intestines as he would have liked, but that there was enough contrast to see that things looked as he expected after reviewing the first scan.
Needless to say, I am enormously relieved that it appears I do not have ANY kind of ovarian tumor (malignant or otherwise). I still have to follow up with my gynecologist next week when she returns from vacation, to see why I am having the abdominal discomfort. In the meantime, I also have an appointment with a gynecological oncologist for August 11. At this point, I think it's likely that I will cancel that appointment after my gynecologist does another pelvic exam and sees the CT films/report. However, if there is any doubt about the diagnosis, I do want to follow up with a gyn-onc just to be sure.
I can't say enough good things about the HysterSisters community and the wonderful support here! Thanks again for all of your good wishes, positive energy and prayers.
All the best,
breathing a BIG sigh of relief after CT scans today showed no ovarian abnormalities; SAH June 2001 for multiple large fibroids, adenomyosis, anemia. Lots of support from HysterSisters then and now!