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Having Fibroids Increase The Risk Of Developing A Cancerous Fibroid?
Question: I had a procedure to remove small polyps and fibroids 5 yrs ago. The procedure did not stop 2 days of heavy menstrual flow each month. Dr felt it was my age. Last year at my annual exam, Dr had no concerns, again my age. Went in February for annual, and Dr found a fibroid. Ultrasound indicated 9 cm. Said she thinks I should have hysterectomy and wants oncologist there just in case. Sent me for MRI. Why would she need an MRI when I had an ultrasound and she is going to do a hysterectomy? I am 47. She said typically these are benign, but because it wasn't detected last year she is concerned.
Brief Answer:
Do the MRI and endometrial sampling
Detailed Answer:
H,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani.
I will be answering your concerns today.
What was the histopathology report of polyps and fibroids before? I presume it was normal. Otherwise your doctor would have discussed it with you.
Your doctor has rightly said that fibroids are typically benign. There is a very small chance of them becoming cancerous (about 1 in 500 fibroids). Cancerous fibroids ( leomyosarcoma) usually occur in women around the age of 60 years. Rarely they are seen in younger women also.
It is difficult to differentiate between the benign fibroids and leomyosarcoma.
Few findings are suspicious and indicate the rare possibility that the fibroid MAY be becoming cancer. They are sudden increase in the size of fibroid, foul smelling vaginal discharge, heavy mensus not responding to hormones like GNRH etc.
Since the fibroid was not seen last year and suddenly this year it is 9 cm in size, your doctor is concerned about the possibility of leomyosarcoma(cancer ) and she is right.
In order to clarify this possibility she has asked for MRI. It is important to do it. Ultrasound is not a helpful investigation in this respect.
I advise you to discuss with your doctor and get an endometrial sampling ( office biopsy of the lining of uterus) done. Some cancers can be be detected by this test.
If there is any suspicion of cancer, I advise you to get hysterectomy done by oncologist. Don't opt for laparoscopic hysterectomy as this procedure may spread the disease.
I hope I have answered your concerns.
If you have any further concerns, do contact me through Healthcare Magic.
Do the MRI and endometrial sampling
Detailed Answer:
H,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani.
I will be answering your concerns today.
What was the histopathology report of polyps and fibroids before? I presume it was normal. Otherwise your doctor would have discussed it with you.
Your doctor has rightly said that fibroids are typically benign. There is a very small chance of them becoming cancerous (about 1 in 500 fibroids). Cancerous fibroids ( leomyosarcoma) usually occur in women around the age of 60 years. Rarely they are seen in younger women also.
It is difficult to differentiate between the benign fibroids and leomyosarcoma.
Few findings are suspicious and indicate the rare possibility that the fibroid MAY be becoming cancer. They are sudden increase in the size of fibroid, foul smelling vaginal discharge, heavy mensus not responding to hormones like GNRH etc.
Since the fibroid was not seen last year and suddenly this year it is 9 cm in size, your doctor is concerned about the possibility of leomyosarcoma(cancer ) and she is right.
In order to clarify this possibility she has asked for MRI. It is important to do it. Ultrasound is not a helpful investigation in this respect.
I advise you to discuss with your doctor and get an endometrial sampling ( office biopsy of the lining of uterus) done. Some cancers can be be detected by this test.
If there is any suspicion of cancer, I advise you to get hysterectomy done by oncologist. Don't opt for laparoscopic hysterectomy as this procedure may spread the disease.
I hope I have answered your concerns.
If you have any further concerns, do contact me through Healthcare Magic.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Is it possible due to position of fibroid, they mentioned on the side of the uterus, that it was not felt during manual exam last year? Also, I have been on weight watchers plan and have lost about 10 pounds in the year since my last exam - down from 143 lb to 133 lb., so maybe since there is less flab on my stomach, it was easier to feel this time around? As mentioned in my last question, I have had heavy periods both before and after last fibroid was removed, which was benign, so heavy periods have become typical for me since I entered age 40.
Brief Answer:
Small possibility that fibroid was missed in last year's examination
Detailed Answer:
Hi,
Yes, if you have thick abdominal wall it may be difficult to feel it in manual examination.
The ultrasound would have picked it up if it was present last year. But there is a possibility of human error too. If the fibroid is in the fundal part of the uterus and if you had only transvaginal ultrasound ( without the abdominal ultrasound) it may not be noticed easily by the probe and it can be missed.
Yes, in your case the heavy period have become typical without apparent cause. May be there were minute fibroid seedlings causing it and you did not use any simple medicines like Mefenamic acid or Tranaxemic acid
Heavy period becomes suspicious if it does not respond even to strong medicines like Gonadotrophin Releasing hormone analogues.
I hope I have answered your concerns.
If you have any further queries, do write to me. I will be happy to answer.
Small possibility that fibroid was missed in last year's examination
Detailed Answer:
Hi,
Yes, if you have thick abdominal wall it may be difficult to feel it in manual examination.
The ultrasound would have picked it up if it was present last year. But there is a possibility of human error too. If the fibroid is in the fundal part of the uterus and if you had only transvaginal ultrasound ( without the abdominal ultrasound) it may not be noticed easily by the probe and it can be missed.
Yes, in your case the heavy period have become typical without apparent cause. May be there were minute fibroid seedlings causing it and you did not use any simple medicines like Mefenamic acid or Tranaxemic acid
Heavy period becomes suspicious if it does not respond even to strong medicines like Gonadotrophin Releasing hormone analogues.
I hope I have answered your concerns.
If you have any further queries, do write to me. I will be happy to answer.
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. Vinay Bhardwaj
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