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What Does This CT Scan Report Indicate?
Question: Follow-up to question answered by Dr. XXXXXXX Brown. Dr. Brown, I got my Catscan records. Report said "The lung bases are clear without focal pulmonary consolidation or fluid; the liver, spleen, adrenal glands, kidneys, pancreas and gallbladder appear unremarkable. The abdominal aorta is normal in caliber. Bowel loops are normal in caliber. There is no bowel obstruction. No retroperitoneal or mesenteric lymphadenopathy is noted. Within the lower pelvis there is evidence of a fluid attenuation cystic lesion measuring 11.2 x 10.5 cm which displaces the bladder inferiorly. The origin of this collection is suspected to be from the right adnexa and ovary. No cystic lesions are noted in the region of the left adnexa. The uterus appears unremarkable. There is moderate degenerative change at L5-S1 of the lumbar spine. Within the right inguinal region anterior to the right common femoral vein is a 2.4 x 1.6 cm fluid attenuation lesion. Correlation with clinical and surgical history is recommended.
Impression 1. Large cystic lesion likely originating from the right ovary. Further evaluation is recommend with ultrasound as well as gynecologic evaluation
2. Small collection in the right inguinal region. This could represent a small seroma or sequela of prior hematoma..."
This seems to indicate there is probably no cancer in other organs, even if the cyst is malignant. Is that correct or wishful thinking? I will be seeing the OBGyn Tuesday but am trying to get my head around this and start looking into the right hospitals, oncologists if need, surgeons etc.
Impression 1. Large cystic lesion likely originating from the right ovary. Further evaluation is recommend with ultrasound as well as gynecologic evaluation
2. Small collection in the right inguinal region. This could represent a small seroma or sequela of prior hematoma..."
This seems to indicate there is probably no cancer in other organs, even if the cyst is malignant. Is that correct or wishful thinking? I will be seeing the OBGyn Tuesday but am trying to get my head around this and start looking into the right hospitals, oncologists if need, surgeons etc.
Brief Answer:
It is true that there are no outside signs of malignancy.
Detailed Answer:
It is good to hear back from you and I appreciate your sending me the actual CT scan report.
You are correct and it is very good that there are no signs of malignancy or metastatic spread on the CT scan. The CT scan also didn't describe solid portions or complex looking areas in the cyst, which are all signs that the cyst is benign. It is still possible however that it is malignant (because it is so big) and just hasn't spread beyond the ovary.
The cyst is still large enough to have risk for rupture though, and the only way to know whether it is benign is to have it removed.
When you see the GYN Tuesday they will likely draw blood tests for what we call tumor markers, especially one called CA-125, and send you for an ultrasound. These tests will give more information about the cyst. CA 125 is elevated in most ovarian cancers, so if that test is negative, that will also be a very good sign. The ultrasound will look at the internal structure which can help diagnose the type of cyst.
So yes- it is very possible that this cyst is benign... and I really hope that turns out to be the case. The CT report has nothing conclusive that shows the cyst is malignant at this point.
I hope you get more reassuring news Tuesday and I know it is impossible not to worry, but at the moment, other than your having a very large ovarian cyst... everything looks very good.
Let me know if you need anything else, and feel free to check in after your doctor's appointment if you want to go over it.
Take care, Dr. Brown
It is true that there are no outside signs of malignancy.
Detailed Answer:
It is good to hear back from you and I appreciate your sending me the actual CT scan report.
You are correct and it is very good that there are no signs of malignancy or metastatic spread on the CT scan. The CT scan also didn't describe solid portions or complex looking areas in the cyst, which are all signs that the cyst is benign. It is still possible however that it is malignant (because it is so big) and just hasn't spread beyond the ovary.
The cyst is still large enough to have risk for rupture though, and the only way to know whether it is benign is to have it removed.
When you see the GYN Tuesday they will likely draw blood tests for what we call tumor markers, especially one called CA-125, and send you for an ultrasound. These tests will give more information about the cyst. CA 125 is elevated in most ovarian cancers, so if that test is negative, that will also be a very good sign. The ultrasound will look at the internal structure which can help diagnose the type of cyst.
So yes- it is very possible that this cyst is benign... and I really hope that turns out to be the case. The CT report has nothing conclusive that shows the cyst is malignant at this point.
I hope you get more reassuring news Tuesday and I know it is impossible not to worry, but at the moment, other than your having a very large ovarian cyst... everything looks very good.
Let me know if you need anything else, and feel free to check in after your doctor's appointment if you want to go over it.
Take care, Dr. Brown
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr. Brown
I saw my OB/GYN today. He said he is almost certain there is no cancer. They drew blood for the tumor marker test and have scheduled me for a ultrasound next week. He said the two tests would tell us whether I should see an oncologist or schedule surgery.
If cancer is not indicated, he said he would remove the cyst lapriscopically. I asked about danger of it bursting and fluids escaping and he said they put a bag around it before removal.
Do you agree this is a reasonable course?
Thanks very much.
I saw my OB/GYN today. He said he is almost certain there is no cancer. They drew blood for the tumor marker test and have scheduled me for a ultrasound next week. He said the two tests would tell us whether I should see an oncologist or schedule surgery.
If cancer is not indicated, he said he would remove the cyst lapriscopically. I asked about danger of it bursting and fluids escaping and he said they put a bag around it before removal.
Do you agree this is a reasonable course?
Thanks very much.
Brief Answer:
Yes it is a good plan!!!
Detailed Answer:
Hello again,
So that is very positive news!!!
It certainly is reasonable for him to attempt a laparoscopy to remove the cyst. Keeping the cyst in a bag, draining and removing it is a standard way we try to remove cysts, so that they don't rupture during surgery, even if they are benign. So what he is recommending is a good and safe way to remove the cyst. Laparoscopy is just as thorough in removing the cyst as open surgery and it will give you a faster recovery.
I would recommend that your surgeon have an oncologist on backup so that if- God forbid, they found out during the surgery that it looks malignant,
the oncologist can complete the surgery. But they don't have GYN oncologists on staff at every hospital. However, if
your CA-125 is negative, it is also reasonable just to take the cyst out and wait for the pathology later.
I am so glad for you that the GYN doctor is so confident it is benign. It is actually not that common for a woman your age to have such a large benign cyst so I'm confident that your doctor is making the correct recommendation for you.
Well, I sincerely wish you the best with your surgery, and I'm happy that this is not looking like the worst scenario.
Take care, and if you need anything else, let me know...
Dr. Brown
Yes it is a good plan!!!
Detailed Answer:
Hello again,
So that is very positive news!!!
It certainly is reasonable for him to attempt a laparoscopy to remove the cyst. Keeping the cyst in a bag, draining and removing it is a standard way we try to remove cysts, so that they don't rupture during surgery, even if they are benign. So what he is recommending is a good and safe way to remove the cyst. Laparoscopy is just as thorough in removing the cyst as open surgery and it will give you a faster recovery.
I would recommend that your surgeon have an oncologist on backup so that if- God forbid, they found out during the surgery that it looks malignant,
the oncologist can complete the surgery. But they don't have GYN oncologists on staff at every hospital. However, if
your CA-125 is negative, it is also reasonable just to take the cyst out and wait for the pathology later.
I am so glad for you that the GYN doctor is so confident it is benign. It is actually not that common for a woman your age to have such a large benign cyst so I'm confident that your doctor is making the correct recommendation for you.
Well, I sincerely wish you the best with your surgery, and I'm happy that this is not looking like the worst scenario.
Take care, and if you need anything else, let me know...
Dr. Brown
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Above answer was peer-reviewed by :
Dr. Raju A.T
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