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CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings?

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Mar 2016
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I had a ct scan and the results came back as follows: (1) bilateral mildly enlarged hypoechoic ovaries, with a 2 cm cystic lesion in left ovary and suspected cystic changes in the right ovary as well. (2) abnormal appearance of the uterus, demonstrating an area of non enhancing fluid, potentially representing injury or other pathology of the endometrium/myometrium. I should note I had a miscarriage 6 weeks ago. I had to have two D&C's. Should I be concerned?
Posted Mon, 16 Dec 2013 in Women's Health
 
 
Answered by Dr. S Patra 1 hour later
Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for writing to us. 1) According to your CT scan report, I can assume that endometrium tissue injury is caused by recent D & C procedure (two times). However, if you don't have any complication or presenting symptom at present, then you don't have to worry much as endometrium tissue will heal up by own within 4 to 8 weeks following D & C or other procedure. In case of irregular bleeding or abnormal discharge, one histopathological (under microscope) examination of endometrial tissue will be worthwhile to rule out the underlying cause or pathology (if any). 2) Bilateral cystic changes or cystic lesion on left ovary (around 2 cm) mostly represents ovarian cyst. Size of the cyst is very small and usually benign in nature. If you don't have any problem with regular period cycle, then it is better to leave alone without any treatment. Otherwise, you can consult with your gynecologist for proper management. Hope, it helps for your information. Let me know, if you need any clarification. Wish your good health and take care yourself. Regards, Dr Soumen For future query, you can directly approach me through WWW.WWWW.WW
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Follow-up: CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings? 11 hours later
Thanks for this information. My biggest concern is around mildly enlarged hypoechoic ovaries. The word hypoechoic usually means cancer, correct? In this case could it mean endometriosis, something else or am I worried for nothing. What prompted all of the tests is due to a lot of lower abdominal, pelvic and back pain. No fevers, discharge or bleeding. I haven't had my period since the miscarriage but also had HCG in my system until about 2 weeks ago. I assume that is why. Doctors also think I have sciatica which may be contributing to low back pain? Question: should I be concerned about the state of my ovaries, noted above? Thanks
 
 
Answered by Dr. S Patra 1 hour later
Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for follow up query. Followings are my comments: 1) Hypoechoic ovaries indicate containing of solid substance. However, it does not mean carcinoma or malignancy always. CT scan alone is not a preferred imaging technique for differentiating nature of the ovarian cyst. Following workout will be helpful to make a concrete diagnosis: a) Trans Vaginal Ultrasound scan with Color Flow Doppler Imaging technique. b) Histopathological examination (Biopsy) of concerned ovarian tissue. c) Blood test for CA 125 and MRI scan (if abnormal report is obtained with above tests). As your CT scan reveals bilateral ovarian cystic lesion without other associated findings, then they are mostly benign in nature. Endometriosis is not so relevant in this context. Kindly, consult with your gynecologist to proceed above tests to rule out exact cause and clear confusion. 2) Lower abdominal pain or backache may be associated with repeated D & C and injury to endometrium. Sciatica is also a relevant cause for the same. You can use muscle relaxant get over back, take hot compression and calcium supplement until you get an appointment to your doctor. Don't be worried much. Hope, I have guided you properly. If you don't have any other query, you can close the discussion. Good luck. All the best. Regards, Dr Soumen
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Follow-up: CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings? 23 minutes later
Thank you. I will contact my doctor. Taking both of your responses in context, should I assume it is most likely benign? The tests would obviously validate that is the case, but you mentioned, in your initial response, that the size was not of concern and to leave it alone without treatment for now. I know I have to do what I am most comfortable with but also don't want to worry needlessly or push for unnecessary tests. Thanks again.
 
 
Answered by Dr. S Patra 29 minutes later
Brief Answer: MOSTLY BENIGN IN MY POINT OF VIEW. Detailed Answer: Hello, Thanks for response. In my point of view, ovarian cystic lesions are mostly benign in nature as there is no other associated findings on CT scan. Here, chance of malignancy is quite low at your age group. However, it would be worthwhile to proceed one pelvic examination and do above tests to confirm the diagnosis. Small size benign ovarian cyst usually doesn't need any treatment if your period becomes regular after initiation. Otherwise, hormonal medication and supportive therapy are required for proper treatment of the case. Hope, it helps for your understanding. Be well and take care. Regards, Dr Soumen
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Follow-up: CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings? 48 hours later
I am also experiencing pain in my right pelvis. It radiates to groin and lower back. I did talk to my gyn and she also doesnt think i have cancer but cant diagbose this pain. A surgical clip was found near right ovary on the CT. She doesnt think this is causing the pain. US of ovaries 3 weeks ago were normal as was the camera scan of my uterus (reason she believes no cancer). Thoughts on pelvic pain? The biggest thing to note is that when i apply pressure to the area, the pain gets much worse for a period of time. Heat does seem to provide some relief but doesnt take pain away conpletely. Lastly, when my doc did the ovary US the pain waa bad afterwards (primarily in groin area). The pelvic hand exam this wee didnt cause the pain to be worse. k
 
 
Answered by Dr. S Patra 7 hours later
Brief Answer: SCIATICA OR INFLAMMATION OF PELVIC ORGAN. Detailed Answer: Hello, Thanks for follow up query. According to your information, I can assume that underlying reason could be the inflammation of pelvic organs or sciatica (as your ultrasound scan normal) which can lead to this type of pain and radiate groin to lower back portion. TREATMENT: You can take NSAIDs (Non-Steroid Anti-Inflammatory Drugs) like combined Aceclofenac with Paracetamol and H2 blocker like Ranitidine (antacid). Pregabalin and Cyanocobalamin (Vitamin B12) are the adjunct drug treatment. It will alleviate your pelvic pain to some extent. Please, procure a prescription from your doctor. Hot compression, physiotherapy and applying muscle relaxant gel are the other option to treat your condition. You should take healthy diet with avoidance of high protein, maintain genital hygiene and take calcium supplement. If your pelvic pain remains same as previous following above therapy, I suggest to undergo one DIAGNOSTIC LAPAROSCOPY to rule out inflammatory changes. Hope, I have guided you properly. Kindly, close the discussion ad rate the answer. Regards, Dr Soumen
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Follow-up: CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings? 35 minutes later
A few questions back. I do feel a knot (larger than a pea and smaller than a matble size). Its in the pelvic area but highwr up (to right above butnear c section scar) When i push on it that is when the pain flares up. I also feel a few smaller knots but they dont cause pain. So sciatica can cause pain in the absomen? Also, do you agree it likely is not cancer?
 
 
Answered by Dr. S Patra 24 minutes later
Brief Answer: POSSIBLY NO CANCER. DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for query. 1) Near C-section scan, feeling of knot is not relevant to your current problem. It is mostly scar tissue and superficial in origin. 2) Pain of Sciatica pain radiate from back portion to lower abdomen. Your clinical picture is mostly suggestive of neurological pain instead of pelvic pathology. Just start above treatment under the guidance of your doctor to get effective result. 3) I don't think your pelvic pain is from cancerous origin. In your age, it is quite unlike. Also, CT scan doesn't reveal the other abnormal findings. So, don't be much worried about this. Hope, it helps for you to understand properly. Kindly, close the discussion. Regards, Dr Soumen
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Follow-up: CT scan showing bilateral mildly enlarged hypoechoic ovaries. Should I be worried about the findings? 10 minutes later
Good to know about the acar. When i feel further, there are three knots practically in a straight line. That actually makes me feel better because they wouldnt be lined up like that, coorect? Your help has been great. Once ii am able to get in with my doc, ahe has provided the same explanation. You mentioned that a CT scan is not the best for this area, which my doc alao said. Did you just mean reproductive organs? A mass would ahow up on a CT scan, correct?
 
 
Answered by Dr. S Patra 17 minutes later
Brief Answer: DON'T BE WORRIED MUCH. FOLLOW THE TREATMENT. Detailed Answer: Hello, Thanks for your response. 1) Yes, scar tissue make you feel like knots on that area in a straight line. It is not relevant with your current problem if the scar is not recent. 2) CT scan shows bilateral cystic changes with predominant 2 cm cyst on the left ovary. This type of clinical picture is very common during reproductive age group. They are mostly benign in nature. However, CT scan alone is not much helpful to rule out the nature of the cyst. In such case, you have to undergo additional tests which are mentioned in my 2nd text. Kindly, consult with your doctor when you get an appointment. Don't be worried unnecessarily. Hope, I have guided you properly. Kindly, close the discussion and rate the answer. All the best and good luck. Be well and take care. Regards, Dr Soumen
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