Question: Hello there,

there is some health problem with my mother who is 68 years old. She had bleeding yesterday morning. We went to consult one doctor here in Mumbai. There were some tests done and we got to know that she has 4mm cyst. But the concern is that in report it came out that the thikness of ovary is 8MM. My mother is also Diabetise and BP patient. Can someone guide me what can be the cause..... is there anything to worry? Tomorrow we are going for CBC, TSH, CA125 tests.

Hello Sir,
I have got the report of CA-125 test.Below is the highlight. Please go through and suggest .

Test Description
Hormones :TSH(Ultrasensitive),serum by CMIA
Observed Value :1.66

Biological Reference Interval:
0.45 to 4.5 IU/mL
Pregnancy :-
First Trimester: 0.1 to 2.5 IU/ml
Second Trimester : 0.2 to 3.0 IU/ml
Third Trimester:: 0.3 to 3.0 IU/ml
Reference:
Guidelines of the American Thyroid Association
During Pregnancy and Postpartum,2011.


Remarks : 1.4.51 to 15 IU/mL - Suggested clinical
co-relation or repeat the test with new sample as physiological factors can give falsely high TSH.
2.TSH values may be transiently altered because of non thyroidal illness like severe infections,liver disease,
renal and heart failure,severe burns, trauma and surgery etc 3.Drugs that decrease TSH values e.g:L-dopa,Glucocorticoids
Drugs that increase TSH values e.g Iodine,Lithium,Amiodarone


Tumor markers
CA-125 (Cancer Antigen-125), serum by CMIA 20.60
0 - 35 U/ml
(Kit insert)
Elevated CA-125 levels may be seen in
non-malignant conditions.
Kindly note the change in the reference range:

1.Levels are increased in non mucinous epithelial ovarian carcinoma, fallopian tube tumors, cervical adenocarcinoma,
endometrial adenocarcinoma, trophoblastic tumors, Non Hodgkins Lymphoma, squamous carcinoma of cervix/vulva,
carcinoma of pancreas, liver or gastrointestinal tract .
2..Multiple serial levels are best for monitoring status .
3.Levels may be increased in pregnancy, menstruation, endometriosis, pleural effusions, cirrhosis and renal
failure .
4.HE4 assay is a new test which also can be used for therapeutic monitoring as well as for risk stratification of
harboring Epithelial Ovarian Cancer (ROMA value).

Thanks for the reply..... In ultrasound a syst of 4mm identified in the left side. The thickness of endometrium is 8 mm. Thats all in that report.

Hello,
the biopsy report has come. And its positive unfortunately. I have only got the verbal confirmation over phone, will get it tomorrow. What are the optiones we have now? I mean which stage uterus removal surgery can be done? Which hospitals are specialized for this treatment and what will be the total costs for the treatment roughly.

Hello,

Thanks for the reply.
Would it be possible that we can have verbal discussion over phone? I just want to make sure that i have all the relevent information about it.

I can understand that there will be some rules and you may not want to share your contact information. In that case i can XXXXXXX you whereever you want or else i can be contacted on my mobile number 0000.

regards\

Hello,

Below is the Biopsy report. Can you please guide further based on this report.
Also would like to know whether we can go for surgery after 3-4 weeks (I mean, would it be too late as far as time concern and is there any strong possiblity that the disease would spread till uncurable stage during 3-4 weeks)?

               

CYTOLOGICAL EXAMINATION


Method:
The smear were fixed in equal parts of ether alcohol
Fixative mixture and then stained by papanicoloau stain

CYTOLOGICAL EXAMINATION:
CERVICAL SMEAR:
The smear shows few superficial cells with pyknotic nuclei and acidophilic cytoplasm and intermediate cells with vesicular ncuclei. Background shows fair number of neutrophils and few red blood cells . Dysplastic or malignant cells are not seen.


               
HISTOPATHOLOGY REPORT


GROSS EXAMINATION:
Received in fixative multiple soft tissue bits aggregating to less than 1 cm labeled as endometrial curettage.
MICROSCOPY EXAMINATION:
H&E stain section shows well differentiated grade 1endometrioid adenocarcinoma of the endometrium.
Also seen are fragments of endocervical mucosa with high grade squamous cell carcinoma in situ.


My mother is in Mumbai currently and i am planning her to bring here in bangalore ASAP before visit you

Note: My mother is also Diabetise and BP patient.

Regards
XXXXXX

Hello,

Thanks for the reply.

As per your advice we are planing this ASAP.

Just to be curious: whether Chemotheropy will be needed before the surgery? And even after ? What's your opinion based on the report?

Regards
XXXXXX