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History of NHL. Having abdominal pain, tingling sensation in knee. Ovary and tube removed. What is causing this?

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39 female history of NHL. complete remission since 06'. No family history of cancers.

For 5 months" lower" isolated- left abdominal pain. Gradually getting worse.Pain has almost "spread" (for a lack of better words but pain also is different sensation) to lower -mainly left leg, knee and calf pain and tingling sensations as well as arm on the left side. Symptoms of that pain, also periodically on right side leg, calf and arm pain.

Last year had a lap and right ovary and tube removed due to cyst. Incision on left ...."still" tender and bigger then on right. Clear colonoscopy. 2 transvaginal sonos show a 1.7 cm cyst on left ovary and was told that was not causing my pain. All blood work cbc, cmp, LDH and other cardic labs normal. Don't want CT due to having one last year and it was normal. Don't want the radiation exposure.

What could be the cause?? I'm having a lap again tues. but don't want undue worry about cancer for DVT. Please let tell me "WHAT" might be the cause of such symptoms.
Posted Sun, 5 Aug 2012 in Abdominal Pain
Answered by Dr. Timothy Raichle 6 hours later

Hello, I would be happy to try and help you with your question.
XXXXXXX I am sorry for what you have gone through. Without discounting your prior history, I am going to summarize your situation as follows:

"A 36 year old with chronic, worsening left lower quadrant pain with a normal colonoscopy, normal pelvic ultrasound and one year ago had a laparoscopy with removal of right tube and ovary, but otherwise normal views of the pelvis"

Hopefully this does justice to your situation. Sometimes my goal as an OB/GYN is just to "rule out" GYN causes of your pain. Given the normal laparoscopy within the year and a normal ultrasound x 2, I am just not sure what they are expecting to find. I am sort of thinking that they will find nothing. Unless you have severe endometriosis, I would make it very clear that you do not want to lose your remaining ovary!.

In terms of the answer to your question, causes of LLQ pain often come down to:

1. GYN sources - I am going to guess not the case
2. GI sources - normal colonoscopy though
3. Musculoskeletal - given the association with your upper and lower extremities, I think this is a better bet
4. Other - this is a long list of uncommon things

So what I would want if I were you (before you put yourself through another surgery) would be additional imaging (such as the CT they recommended) or an MRI to look at the spine (given the involvement of upper and lower extremities).

It is okay to ask for a second opinion. I hope this helps. If you have more questions, please ask. I would really appreciate if you would accept my question once you are satisfied.
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Follow-up: History of NHL. Having abdominal pain, tingling sensation in knee. Ovary and tube removed. What is causing this? 11 hours later
Thank you so much for your thoughts and information I really appreciate you taking the time. I will proceed with that advice and request the MRI first!

Kind Regards,
Answered by Dr. Timothy Raichle 7 hours later

Thank you for the followup. This is a great place to start. If you have followup questions, please direct them to me and I will be happy to help.

Please don't forget to ACCEPT this question so that I receive credit from HealthCare Magic!

Dr. R
Above answer was peer-reviewed by
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