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What does my ultrasound scan report indicate?

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Posted on Fri, 3 Mar 2017
Question: My daughter has a "spot" or that is approx 6 cms in size on the side of her uterus. It was discovered when she had an ultra sound following the delivery of her twins that died at 19 weeks because the placenta pulled away from the uterine wall. Her ob-gyn has indicated the "spot" is very vascular and it was seen again this past week, 7 weeks following the date she delivered the twins. The size of this spot has not changed. An MRI has been requested to supposedly better determine what this "spot" may be. Could this be a fibroid - can they be vascular? They her doctor thought it may be a piece of placenta, but they think she would have passed that by now. The doctor is concerned about performing a D&C (?) because this spot is so vascular, and the chance of something going wrong - which could then result in a hysterectomy having to be performed. This is all very scary, especially for my daughter who has no children yet. I'm seeking any ideas or input you may have as to what this "spot" may be and /or how to find out what it may be, cancer or other. Thank you.
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Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
Fibroids are not vascular

Detailed Answer:
Hi
Thanks for your query.

Fibroids are usually not vascular. It may be a retained part of placenta. The MRI should be able to diagnose it correctly. If looking like retained placenta, then D and C can be done. Don't think it will necessitate hysterectomy.

Another thing that should be ruled out is gestational trophoblastic neoplasia, which is basically a cancer arising from the placental tissue. To rule this out, serum beta HCG should be performed serially. It should come down progressively. If plateauing or increasing, it may be cancerous.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh (1 hour later)
The OB-GYN seemed to rule out the "spot" being a retained part of the placenta. Could a left-over piece of placenta possibly be vascular??

You suggest a serum beta HCG should be performed serially to rule out whether or not the spot is a cancer arising from the placental tissue. I know what HCG is but I do not understand what you mean by serially.

Thank you.
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
If attached to uterus it can be vascular

Detailed Answer:
By serially I mean that if abnormal, it has to be repeated every 1-2 weekly till it becomes normal. If it remains high then gestational trophoblastic neoplasia can be there.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Indranil Ghosh

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Practicing since :2004

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What does my ultrasound scan report indicate?

Brief Answer: Fibroids are not vascular Detailed Answer: Hi Thanks for your query. Fibroids are usually not vascular. It may be a retained part of placenta. The MRI should be able to diagnose it correctly. If looking like retained placenta, then D and C can be done. Don't think it will necessitate hysterectomy. Another thing that should be ruled out is gestational trophoblastic neoplasia, which is basically a cancer arising from the placental tissue. To rule this out, serum beta HCG should be performed serially. It should come down progressively. If plateauing or increasing, it may be cancerous. Hope this helps. Regards