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What do these ultrasound and CT scan reports indicate?

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Posted on Wed, 25 Nov 2015
Question: Hi. I have a follow-up ultrasound this Friday. My story is as follows . I had a transvaginal ultrasound back in the middle of August due to some bloating, fullness , etc.. I was told all was fine. I also had an abdominal ultrasound , all

Was fine . My symptoms went away after about 3 weeks. ( gastro though some sort of bug that causes gastritis ). Come middle of Septmeber, I began to have lower abdominal issues, diarrhea , urgency( of stools ). My gastroenterologist said to have a ct scan ( had had a colonoscopy 20 months ago and all was fine) . So the Ct scan ( done September 24, 6 weeks after ultrasound ) showed I had a possible multiloculated right Ovarian cyst( nothing else ) 4.8x2.7 cm . My regular doctor said to see my gyn . Of course I was surprised that a cyst was there as I was told everything was fine after ultrasound In August . Saw my gyn and she said I had a baby cyst ( one on each ovary ) back in August . The one I the left must have dissolved . Anyway. She said she believes it

Is a hemogrraphic cyst and had me follow up in 5 weeks .( this Friday ). As time has gotten closer , I have become more nervous . She has told me repeatedly if she was concerned of malignancy , she would not have had me wait . Can the type of cyst been seen clearly even when it is a baby cyst ( I understand that the type of cyst can not be seen with 100%) accuracy , but I guess I want to get a sense . I have had no pain . My September period was different , but October 's period was normal. I am 47 btw..

My gyn did not want to do 125

Test because she knows of possible false positives and did not want to increase my anxiety . I have been taking apple code vinegar,'just started applying castor oil and am seeing an acupuncturist . With all of those other tests , would anything else be out of order if there was a chance of malignancy ? Any feedback and possible reassurance you can give would be great . Thanks
doctor
Answered by Dr. Munish Sood (1 hour later)
Brief Answer:
could be benign cyst with present investigation

Detailed Answer:
Dear
Thanks for contacting with your concern and following is/are recommended guidelines after going through your medical history:

1. Since you are under regular supervision thus your attending physician is already on the right track because:

a. Since she has done with ultrasound & CT scan which means that already MALIGNANCY is excluded.

PS. CT scan cannot predict whether the resulting image is Malignant,it is done to know whether there is Metastatis (spreading) or not

b. CA-125 will not cause anxiety but will helo to overcome anxiety, since if the report come abnormal then she will preferably refer you to " gynecologist oncologist"

PS. Rising CA-125, ovarian size may ask for surgical evaluation.

c. If one thinks of any abnormality then one may ask for test like: chest x-ray, PET scan, barium enema x-ray and serial ultrasound.

PS. ultrasound mainly to know any imcrease in size of the cyst and other to know for any metastasis.

d. If thinking of any malignancy, then one should check with:
.Hcg (human chorionic gonadotropin)
.AFP (alfa feto protein)
.LDH (lactate dehydrogenase)

PS. You may also consider checking level of Inhibin, estrogen and testosterone.

e. At present: given your history, physical examination and investigation done by your gynecologist it probably seems to be benign (non cancerous) cyst thus keep a regular follow up with your doctor and remain under her supervision.

Dr. Munish Sood
Consultant & Physician
Naimittika

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Munish Sood (21 minutes later)
Thank you for your response. IF this is in fact a hemograpphic cyst, how quickly can they dissolve? Can they grow that quickly from a baby cyst in mid August to the 2.8x4.7 cm in September? So we know at this point if it were malignant, it has not spread elsewhere.... can a transvaginal ultrasound be pretty clear about what type of cyst it is? If my doctor did not ask for me to have it removed, can I assume she is feeling confident about what it might be? Thanks.
doctor
Answered by Dr. Munish Sood (39 minutes later)
Brief Answer:
further clarification

Detailed Answer:
Dear
Thanks for reverting back

1. Since fluid filled cyst can increase in size quickly thus could be the case in you.

2. Although transvaginal ultrasound can help in diagnosing cyst but with the help of clinical parameters, color doopler,CA-125 measurement it help to differentiate functional cyst from other adenexal mass.

3. Yes your present physician has undertook all the relevant examination and necessary investigations to make sure that presently the condition can be managed with conservative line of treatment.

Dr. Munish
Naimittika
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Munish Sood (29 minutes later)
Thank you for your feedback.Do you feel that I do not have to be so nervous/anxious about my ultrasound on Friday?
doctor
Answered by Dr. Munish Sood (19 minutes later)
Brief Answer:
no need to panic

Detailed Answer:
Dear
Thanks for reverting back

1. Since presence/discovery of cyst itself is a cause of anxiety in women but good thing is that these cyst are usually benign and asymptomatic (unless proved othwewise)

PS. the ideal investigation will then be:
. serial ultrasound
. rising CA-125 level
. histopathology (biopsy)

2. Feel comfortable about your coming ultrasound and hopefully everything turns to be alright and do let me know about the same directly on:
bit.ly/drmunishsood

Dr. Munish
Naimittika.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Munish Sood (2 hours later)
Thank you for your your feedback and reassurance. I know the chance of malignancy is very small and know my doctor(who I trust) would have had me come in to get it removed if she was concerned. I have very bad health anxiety and just want to not have to worry. I know I am catching it early even if it turns out to be malignant(which, of course, i don't want it to be). Thanks again!
doctor
Answered by Dr. Munish Sood (3 hours later)
Brief Answer:
health anxiety and reassurance

Detailed Answer:
Dear
Thanks for reverting back.

Anxiety is a common feature with anyone under going medical examination and awaiting results, so best is to have full faith in yourself and the coming examination, as certainly once the results are out it will not only alleviate your anxiety but will also reassure your health issues and belief on your attending doctor.

Dr. Munish
Naimittika
Above answer was peer-reviewed by : Dr. Sonia Raina
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Dr. Munish Sood

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What do these ultrasound and CT scan reports indicate?

Brief Answer: could be benign cyst with present investigation Detailed Answer: Dear Thanks for contacting with your concern and following is/are recommended guidelines after going through your medical history: 1. Since you are under regular supervision thus your attending physician is already on the right track because: a. Since she has done with ultrasound & CT scan which means that already MALIGNANCY is excluded. PS. CT scan cannot predict whether the resulting image is Malignant,it is done to know whether there is Metastatis (spreading) or not b. CA-125 will not cause anxiety but will helo to overcome anxiety, since if the report come abnormal then she will preferably refer you to " gynecologist oncologist" PS. Rising CA-125, ovarian size may ask for surgical evaluation. c. If one thinks of any abnormality then one may ask for test like: chest x-ray, PET scan, barium enema x-ray and serial ultrasound. PS. ultrasound mainly to know any imcrease in size of the cyst and other to know for any metastasis. d. If thinking of any malignancy, then one should check with: .Hcg (human chorionic gonadotropin) .AFP (alfa feto protein) .LDH (lactate dehydrogenase) PS. You may also consider checking level of Inhibin, estrogen and testosterone. e. At present: given your history, physical examination and investigation done by your gynecologist it probably seems to be benign (non cancerous) cyst thus keep a regular follow up with your doctor and remain under her supervision. Dr. Munish Sood Consultant & Physician Naimittika