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What Does This Ultrasound Report Indicate?
Question: One of my female friend aged 24, not have periods for 4 months has been diaglozed in ultrasound with " Right Adnexa showing complex cystic - solid lesion measuring 11.2* 6.2* 6.0 cms. The right ovary is not seen separately. What should be our future course of action? She has also been advised a CA 125 test. Please advice.
Brief Answer:
Please upload the report.
Detailed Answer:
Hello
Thanks for trusting us with your health concern.
Would you please upload the exact scan report with images ?
So that I can go through it , and guide you further ?
Does she have any past / family history of cancers or tumours ?
Looking forward to hearing from you.
Take care.
Please upload the report.
Detailed Answer:
Hello
Thanks for trusting us with your health concern.
Would you please upload the exact scan report with images ?
So that I can go through it , and guide you further ?
Does she have any past / family history of cancers or tumours ?
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor, the report has been uploaded. Please have a look. No, she does not have a past family history of cancers/ tumors. Although, she herself had some harmonal issues a couple of years back of non stop periods but that was treated with a month long medication. Please advice
Brief Answer:
As below
Detailed Answer:
Thank you for the updates.
This is an mass ( tumour ) on the ovary.
It is less likely to be malignant ( cancerous ).
However, that possibility has to be ruled out.
You should get a CA 125 test done, and upload the report to me.
I can see the address of XXXXXXX Vihar, and I was practising in Indraprastha Apollo ( jasola ) myself for quite some time.
Once that report comes, I will guide you further.
Surgery is compulsory in her case, you should try and find an Expert who will operate upon her laparoscopically ( without stitches ) .
I will give you due suggestions.
Please get the CA 125 test done and also MRI / CT scan done .
Take care.
As below
Detailed Answer:
Thank you for the updates.
This is an mass ( tumour ) on the ovary.
It is less likely to be malignant ( cancerous ).
However, that possibility has to be ruled out.
You should get a CA 125 test done, and upload the report to me.
I can see the address of XXXXXXX Vihar, and I was practising in Indraprastha Apollo ( jasola ) myself for quite some time.
Once that report comes, I will guide you further.
Surgery is compulsory in her case, you should try and find an Expert who will operate upon her laparoscopically ( without stitches ) .
I will give you due suggestions.
Please get the CA 125 test done and also MRI / CT scan done .
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Mam. She went to Holy Family Hospital today and she has been advised CT Scan and Ca 125. Post that, only will they be able to decide whether to go for surgery or go with medication. The date given by them for CT Scan is 20th Sept.
May I request you for following:
a. Can you please let me know of the cost of laparoscopic surgery (approx), if they decide to do one? I need to know this since they have some financial issues as well.
b. Is holy family a good hospital for such procedures?
c. Any contact number of yours for future correspondence?
Regards,
May I request you for following:
a. Can you please let me know of the cost of laparoscopic surgery (approx), if they decide to do one? I need to know this since they have some financial issues as well.
b. Is holy family a good hospital for such procedures?
c. Any contact number of yours for future correspondence?
Regards,
Brief Answer:
As below
Detailed Answer:
Hello dear
Sorry for the delayed reply as there were some internet connectivity issues at my end.
Yes decision further can only be taken after CT scan and blood report.
I do not know anybody personally in Holy Family Hospital.
It is not famous for laparoscopic surgery.
If you know which doctor is going to do it please let me know the name , maybe I might shed some light on it.
Cost if surgery varies from hospital to hospital and doctor to doctor.
But in private hospital it will be costly and would be more affordable in govt set up like XXXXXXX unless they have medical insurance.
The website does not allow me to share my personal email or phone numbers, sorry.
Take care and let me know the reports.
All the best
As below
Detailed Answer:
Hello dear
Sorry for the delayed reply as there were some internet connectivity issues at my end.
Yes decision further can only be taken after CT scan and blood report.
I do not know anybody personally in Holy Family Hospital.
It is not famous for laparoscopic surgery.
If you know which doctor is going to do it please let me know the name , maybe I might shed some light on it.
Cost if surgery varies from hospital to hospital and doctor to doctor.
But in private hospital it will be costly and would be more affordable in govt set up like XXXXXXX unless they have medical insurance.
The website does not allow me to share my personal email or phone numbers, sorry.
Take care and let me know the reports.
All the best
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear Doctor,
I have uploaded Ca 125 report which I know is not at all good. Please share your views. How should we read and what should be the future course of action. Do such high levels indicate a malignant tumor will come up in CT scan?
CT scan will take place on 20th and will upload the details when I have it.
Just and added information: Before going to Holy family, she had gone to her family physician on Wednesday. The physician gave her 2 tablets to eat for three times a day for three days (the name of the tablets we don't know since it was given by physician herself) . She said, take these for three days and periods will take place by Sunday which did not happen. Hence just wanted to know, could that medicine have impacted such high levels in CA 125? The CA 125 sample was given today (Sunday) itself. Please share your views on all these.
Regards.
I have uploaded Ca 125 report which I know is not at all good. Please share your views. How should we read and what should be the future course of action. Do such high levels indicate a malignant tumor will come up in CT scan?
CT scan will take place on 20th and will upload the details when I have it.
Just and added information: Before going to Holy family, she had gone to her family physician on Wednesday. The physician gave her 2 tablets to eat for three times a day for three days (the name of the tablets we don't know since it was given by physician herself) . She said, take these for three days and periods will take place by Sunday which did not happen. Hence just wanted to know, could that medicine have impacted such high levels in CA 125? The CA 125 sample was given today (Sunday) itself. Please share your views on all these.
Regards.
Brief Answer:
As below
Detailed Answer:
Please let me know the CT scan report too.
Yes, the CA 125 level is high, there is a possibility of malignancy, but high levels are sometimes seen in benign ( non cancerous ) masses also.
I will give you my further opinion after seeing both the reports ( CA 125 plus the CT scan ) together.
NO, the tablets to have the period will not lead to the high levels in CA 125.
Please upload the CT scan report at the earliest.
Take care.
Will revert once I go through the report.
As below
Detailed Answer:
Please let me know the CT scan report too.
Yes, the CA 125 level is high, there is a possibility of malignancy, but high levels are sometimes seen in benign ( non cancerous ) masses also.
I will give you my further opinion after seeing both the reports ( CA 125 plus the CT scan ) together.
NO, the tablets to have the period will not lead to the high levels in CA 125.
Please upload the CT scan report at the earliest.
Take care.
Will revert once I go through the report.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
She went for the CT scan today. But the lab technicians said that its better to get an MRI rather than CT scan in this case.
The doctor wasn't available today to prescribe it hence they have called her tomorrow for the MRI. They spoke to the doctor over the phone.
Just wanted to ask, what could be the possible reason why they have now decided to do MRI instead of CT scan?
Regards, XXXXXXX
She went for the CT scan today. But the lab technicians said that its better to get an MRI rather than CT scan in this case.
The doctor wasn't available today to prescribe it hence they have called her tomorrow for the MRI. They spoke to the doctor over the phone.
Just wanted to ask, what could be the possible reason why they have now decided to do MRI instead of CT scan?
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Dont trust the lab technicians.
If the doctor has decided to do MRI, it would be a good decision.
MRI sometimes shows tumour details better than CT scan, the doctor would decide since he / she has personally seen the patient.
Let me know the result anyway.
Take care.
As below
Detailed Answer:
Dont trust the lab technicians.
If the doctor has decided to do MRI, it would be a good decision.
MRI sometimes shows tumour details better than CT scan, the doctor would decide since he / she has personally seen the patient.
Let me know the result anyway.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
She got the MRI done today. The hospital will give the report on Saturday.I will share it as soon as we get it.
Meanwhile, she is having some bleeding since last three days (just droplets of blood with white discharge which she says is mucus in nature). Kindly let us know what is this about?
Is this is the outcome of the periods medicine that she had a few days back or is it something else?
She got the MRI done today. The hospital will give the report on Saturday.I will share it as soon as we get it.
Meanwhile, she is having some bleeding since last three days (just droplets of blood with white discharge which she says is mucus in nature). Kindly let us know what is this about?
Is this is the outcome of the periods medicine that she had a few days back or is it something else?
Brief Answer:
As below
Detailed Answer:
Yes it is most likely the outcome of the medicine that she took for her periods.
Take care, and waiting for the report.
This is the direct link to my profile, so that even in future, you can just click on it, and contact me directly -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
As below
Detailed Answer:
Yes it is most likely the outcome of the medicine that she took for her periods.
Take care, and waiting for the report.
This is the direct link to my profile, so that even in future, you can just click on it, and contact me directly -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear doctor I have uploaded the MRI report. Please share your views.
Brief Answer:
As below
Detailed Answer:
There is only one page of the MRI report uploaded.
Please upload the complete report ( all pages ).
Also, remove all other attachments to avoid confusion.
Just upload all complete pages of the report.
Take care.
As below
Detailed Answer:
There is only one page of the MRI report uploaded.
Please upload the complete report ( all pages ).
Also, remove all other attachments to avoid confusion.
Just upload all complete pages of the report.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Sorry for the inconvenience. I have uploaded both the pages of the report. There were only 2 pages. Kindly reply at the earliest.
Regards, XXXXXXX
Sorry for the inconvenience. I have uploaded both the pages of the report. There were only 2 pages. Kindly reply at the earliest.
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
I have good news !
After the MRI, I think the lesion is most likely to be benign ( non cancerous ) in nature.
I can assure you that I can handle this case Laparoscopically if you come to XXXXXXX ( XXXXXXX Asia Hospital ).
However, for XXXXXXX I am not able to give you proper references unfortunately as I do not personally trust anybody to remove such a huge mass laparoscopically.
It is very important to get it done laparoscopically because she is a young unmarried girl with her entire future life ahead of her.
The MRI is strongly suggestive of non cancerous lesion, so that is really good news.
Of course, the definitive diagnosis is after a biopsy.
Take care.
As below
Detailed Answer:
I have good news !
After the MRI, I think the lesion is most likely to be benign ( non cancerous ) in nature.
I can assure you that I can handle this case Laparoscopically if you come to XXXXXXX ( XXXXXXX Asia Hospital ).
However, for XXXXXXX I am not able to give you proper references unfortunately as I do not personally trust anybody to remove such a huge mass laparoscopically.
It is very important to get it done laparoscopically because she is a young unmarried girl with her entire future life ahead of her.
The MRI is strongly suggestive of non cancerous lesion, so that is really good news.
Of course, the definitive diagnosis is after a biopsy.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Many thanks for the news. It surely is a reliever!!! However, I understand we need to wait for the Biopsy.
After having in depth conversation with you for a while, I have no doubts that you would be able to do Lapro better than many, but convincing her family to travel all the way to Ahmadabad would be difficult. But I will still give it a shot after we show this report to Dr. XXXXXXX Gulleria in Holy Family Hospital tomorrow morning. Another reason, as i informed earlier is the financial part.
Just few more queries:
1. On Mri: I know I should not be doing this, but I have been reading a lot these days about her illness on the internet. Now, after i received the MRI yesterday and before I read your reply, I had already read a lot on the internet about the findings mentioned on the MRI. At many places, words such as Heterogeneity, fats, solid components etc were imaging characteristics associated with Immature Terotoma and hence I got really anxious. May i request you to throw some light on these aspects as to to what makes you think its Benign. Sorry, I am asking this, but this is just to clear the air of all the garbage I have read on the internet recently.
2- On Follow up - Now, when the Holi Family Doctor, XXXXXXX Gulleria advised for the MRI, she had already seen the Ultrasound and CA 125. So based on these, she said that there is an 80 percent chance of an open surgery. Now, she will see the MRI tomorrow and her opinion might change, I dont know. I will update you what she has to say tomorrow. In your previous reply you had stressed on the need for a Lapro. Just wanted to ask as to what are problem areas that an open surgery can create for her in the future?
3- We were also thinking of consulting a Govt hospital and Lady Hardinge Hospital is one such hospital that comes to mind. How good is it for such advice?
4- She has a medical cover of upto 1 Lakh. Just wanted an opinion whether this is sufficient for Lapro or an open surgury whatever is advised at the end?
Regards, XXXXXXX
Many thanks for the news. It surely is a reliever!!! However, I understand we need to wait for the Biopsy.
After having in depth conversation with you for a while, I have no doubts that you would be able to do Lapro better than many, but convincing her family to travel all the way to Ahmadabad would be difficult. But I will still give it a shot after we show this report to Dr. XXXXXXX Gulleria in Holy Family Hospital tomorrow morning. Another reason, as i informed earlier is the financial part.
Just few more queries:
1. On Mri: I know I should not be doing this, but I have been reading a lot these days about her illness on the internet. Now, after i received the MRI yesterday and before I read your reply, I had already read a lot on the internet about the findings mentioned on the MRI. At many places, words such as Heterogeneity, fats, solid components etc were imaging characteristics associated with Immature Terotoma and hence I got really anxious. May i request you to throw some light on these aspects as to to what makes you think its Benign. Sorry, I am asking this, but this is just to clear the air of all the garbage I have read on the internet recently.
2- On Follow up - Now, when the Holi Family Doctor, XXXXXXX Gulleria advised for the MRI, she had already seen the Ultrasound and CA 125. So based on these, she said that there is an 80 percent chance of an open surgery. Now, she will see the MRI tomorrow and her opinion might change, I dont know. I will update you what she has to say tomorrow. In your previous reply you had stressed on the need for a Lapro. Just wanted to ask as to what are problem areas that an open surgery can create for her in the future?
3- We were also thinking of consulting a Govt hospital and Lady Hardinge Hospital is one such hospital that comes to mind. How good is it for such advice?
4- She has a medical cover of upto 1 Lakh. Just wanted an opinion whether this is sufficient for Lapro or an open surgury whatever is advised at the end?
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Hello again.
1. The internet is not often a very reliable or precise source of information for non medical people. Immature teratoma is more dangerous than mature one, but the MRI gives no indication of invasion / spread to neighbouring organs, which is why I believe it is not aggressive or invasive. OF course, only biopsy is conclusive.
2. Open surgery creates a big scar. It leads to future adhesions, difficulty in future fertility, delivery , recovery, everything. For a young unmarried girl, it is the worst way to operate.
3. Government hospitals will always do open surgery since they lack doctors trained in laparoscopy but it never harms to get one more opinion.
4. Cost is relative, depends on the city, mode of surgery, doctor expertise etc. One cannot generalize.
Take care.
As below
Detailed Answer:
Hello again.
1. The internet is not often a very reliable or precise source of information for non medical people. Immature teratoma is more dangerous than mature one, but the MRI gives no indication of invasion / spread to neighbouring organs, which is why I believe it is not aggressive or invasive. OF course, only biopsy is conclusive.
2. Open surgery creates a big scar. It leads to future adhesions, difficulty in future fertility, delivery , recovery, everything. For a young unmarried girl, it is the worst way to operate.
3. Government hospitals will always do open surgery since they lack doctors trained in laparoscopy but it never harms to get one more opinion.
4. Cost is relative, depends on the city, mode of surgery, doctor expertise etc. One cannot generalize.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thanks for your reply.
They went to show MRI to their doctor at Holy Family. She will have to go for an open surgery. The reason given by the doctor is that in an open surgery, everything is in front of them since it is a big cyst and an open surgery will ensure that nothing is left behind. They have said that the recovery period will be around a month.
I exercised the opinion of Ahmadabad with them but her family seems convinced with the doctor at Holy Family.
Although I was personally not present there but doctor told her that they would make a define/ fine U shape cut which will not be too big.
1- Please throw some light on the analysis of the Holy family doctor.
2- Also, forgot to ask the previous time. Is there some infection in the Liver as per MRI? If yes what is it and the possible reason behind it?
3- As for Biopsy, how much time does it take after the surgery for the report to be out?
Regards, XXXXXXX
Thanks for your reply.
They went to show MRI to their doctor at Holy Family. She will have to go for an open surgery. The reason given by the doctor is that in an open surgery, everything is in front of them since it is a big cyst and an open surgery will ensure that nothing is left behind. They have said that the recovery period will be around a month.
I exercised the opinion of Ahmadabad with them but her family seems convinced with the doctor at Holy Family.
Although I was personally not present there but doctor told her that they would make a define/ fine U shape cut which will not be too big.
1- Please throw some light on the analysis of the Holy family doctor.
2- Also, forgot to ask the previous time. Is there some infection in the Liver as per MRI? If yes what is it and the possible reason behind it?
3- As for Biopsy, how much time does it take after the surgery for the report to be out?
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Hello.
Most doctors are not trained or experts in laparoscopy, so they would prefer open surgery.
I do not agree with the analysis of the Holy Family doctor.
Laparoscopy is best for any person, as it has faster recovery and no scar / stitches.
Open surgery should be avoided at any cost.
No there is no problem with the liver.
THe biopsy report is generally available within 5 - 7 days of surgery.
Take care.
As below
Detailed Answer:
Hello.
Most doctors are not trained or experts in laparoscopy, so they would prefer open surgery.
I do not agree with the analysis of the Holy Family doctor.
Laparoscopy is best for any person, as it has faster recovery and no scar / stitches.
Open surgery should be avoided at any cost.
No there is no problem with the liver.
THe biopsy report is generally available within 5 - 7 days of surgery.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Doctor,
Many thanks for your reply. She is currently undergoing some routine blood tests before a final call is taken for the surgery. I will keep you updated on the progress.
Have one Query: If the MRI is strongly suggestive of Benign cyst, then why does she have such high CA 125 level (151) as you may have seen in an earlier report?. Is it normal in cases like her? Do Benign conditions also lead to high CA 125, especially cases like her?
Regards, XXXXXXX
Many thanks for your reply. She is currently undergoing some routine blood tests before a final call is taken for the surgery. I will keep you updated on the progress.
Have one Query: If the MRI is strongly suggestive of Benign cyst, then why does she have such high CA 125 level (151) as you may have seen in an earlier report?. Is it normal in cases like her? Do Benign conditions also lead to high CA 125, especially cases like her?
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Okay, let me know the updates.
High CA 125 levels are also found in benign ( non cancerous ) ovarian masses.
CA 125 is more important to monitor response to therapy in cases of ovarian cancer, rather than deciding which mass is cancerous or not.
Take care.
As below
Detailed Answer:
Okay, let me know the updates.
High CA 125 levels are also found in benign ( non cancerous ) ovarian masses.
CA 125 is more important to monitor response to therapy in cases of ovarian cancer, rather than deciding which mass is cancerous or not.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
She underwent Laprotomy today at Holy Family hospital. Her Cyst has been removed completely. However, they had to remove some part of her right Ovary as well which may have got damaged due to Tumor but they have preserved some part as well and is functional. They did not touch the left Ovary or any other part of the Uterus. She is doing fine now and is in Post Operative room and most probably will be shifted to her ward tomorrow.
Taking further, I could not meet the XXXXXXX doctor today but had a brief conversation with her Junior.
1- They had send the Tumor for Biopsy.
2- Also, they had send the Liquid/ fluid that may have been present in the area for Testing. Why have they sent this? Is it Routine?
3- Also, they had found some Mud/ cheezy material from Liver/stomach and around Ovary which they suspect could be a sign of TB. They are conducting a test for it as well. Do you think it could be TB? If they suspect TB, should the Malignancy be ruled out now?
Kindly share your views.
Regards, XXXXXXX
She underwent Laprotomy today at Holy Family hospital. Her Cyst has been removed completely. However, they had to remove some part of her right Ovary as well which may have got damaged due to Tumor but they have preserved some part as well and is functional. They did not touch the left Ovary or any other part of the Uterus. She is doing fine now and is in Post Operative room and most probably will be shifted to her ward tomorrow.
Taking further, I could not meet the XXXXXXX doctor today but had a brief conversation with her Junior.
1- They had send the Tumor for Biopsy.
2- Also, they had send the Liquid/ fluid that may have been present in the area for Testing. Why have they sent this? Is it Routine?
3- Also, they had found some Mud/ cheezy material from Liver/stomach and around Ovary which they suspect could be a sign of TB. They are conducting a test for it as well. Do you think it could be TB? If they suspect TB, should the Malignancy be ruled out now?
Kindly share your views.
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Can you please send me the operative records / details so that I can comment further on your questions ?
There will be operative notes written by the doctor.
Can you access that ?
As below
Detailed Answer:
Can you please send me the operative records / details so that I can comment further on your questions ?
There will be operative notes written by the doctor.
Can you access that ?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Sorry for the delayed response, since I was inquiring about the records. As of now, we don't have access to the notes. But the doctor has informed that she will be discharged from the hospital tomorrow morning since she has recovered with good speed post surgery and her stool passage is normal too. She also said that all her reports are normal. They still await one report (Dont know which one it is). The junior doctor told me that the histopathological report is normal too but I haven't had a detailed word with the main doctor on this.
I will share the discharge summary and the notes with you tomorrow, once the file handover is done.
Regards, XXXXXXX
Sorry for the delayed response, since I was inquiring about the records. As of now, we don't have access to the notes. But the doctor has informed that she will be discharged from the hospital tomorrow morning since she has recovered with good speed post surgery and her stool passage is normal too. She also said that all her reports are normal. They still await one report (Dont know which one it is). The junior doctor told me that the histopathological report is normal too but I haven't had a detailed word with the main doctor on this.
I will share the discharge summary and the notes with you tomorrow, once the file handover is done.
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Yes please share all the records.
Take care.
As below
Detailed Answer:
Yes please share all the records.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
She was discharged from the hospital and is recovering well. I have attached her discharge summary and histopathological report.
Please have a look and share your views.
Regards, XXXXXXX
She was discharged from the hospital and is recovering well. I have attached her discharge summary and histopathological report.
Please have a look and share your views.
Regards, XXXXXXX
Brief Answer:
As below
Detailed Answer:
Hello again.
Sorry for the delayed reply, there was an internet connectivity issue at my end.
There is no cancer anywhere, as I told you, after looking at the MRI report.
Further analysis of the fluid should be sent also, so that I can comment definitively about tuberculosis also.
Take care.
As below
Detailed Answer:
Hello again.
Sorry for the delayed reply, there was an internet connectivity issue at my end.
There is no cancer anywhere, as I told you, after looking at the MRI report.
Further analysis of the fluid should be sent also, so that I can comment definitively about tuberculosis also.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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