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What Causes Swollen Ovaries?

Posted on Tue, 29 Dec 2015

Question: Hello I have had a scan which shows enlarged ovaries one being with heterogenous texture and the other with tow simple cysts.Is this something to be worried about? My uterus endometrium all ok except one small fibroid.no free fluid seen.i am being referred to a gynocologist.many thanks XXXX

Answered by Dr. Deepti Verma (2 minutes later)

Brief Answer:
Please upload the reports

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
The diagnosis and concern depends upon the size of enlarged ovaries and size of the simple cysts.
Please upload the report so that I can review it completely and give you a clear answer.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (17 minutes later)

My ovary with two simple cysts measure 1.9 x 0.9cm and 3 X1.8 x3.4cm.the ovary is 32cc.the enlarged ovary with heterogenous texture just says 16cc on report.

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Regular follow up ultrasounds required

Detailed Answer:
Hi dear, the ovarian size is definitely larger for your age.
Moreover, the cyst is borderline in size.
However, since the cyst is clear, you need ovary as ovarian cancer is ruled out.
No active treatment is required at present, however 6 monthly ultrasound should be done to assess the changes of ovarian size and cyst, and get appropriate treatment, when required.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (33 minutes later)

Thank you could you tell me what the heterogenous texture in my other ovary could be please? All it said was enlarged at 16cc with heterogenous texture is this why I've been referred? Is it something to worry about? I don't think she was worried about the cysts it was the heterogenous texture why I got referred ? Could you explain what this is please many thanks XXXX

Answered by Dr. Deepti Verma (7 hours later)

Brief Answer:
Ovarian malignancy should be ruled out

Detailed Answer:
Hi dear, heterogeneous texture of the ovaries can be due to ovarian malignancy, and that is why you are being referred to a gynecologist.
You need a Doppler ultrasound and blood CA 125 to assess whether the there is any possibility of ovarian cancer or not.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (6 hours later)

Oh dear that doesn't sound good !! Why haven't they referred me urgently to gyno if this is the case? What benign findings of this Heterogenous texture could there be? Is there anything else the sonigrapher would have picked up if it was anything sinister?I don't understand why it isn't a urgent referral? I had my scan on 19th nov surely I would have been seen by now if they suspected ovarian cancer?

Answered by Dr. Deepti Verma (5 hours later)

Brief Answer:
Very low chances of malignancy

Detailed Answer:
Hi dear,
Please do not panic. Ideally, you should have been worked up with colour doppler ultrasound and CA 125 levels soon after this ultrasound report had come.
However, much time has not elapsed and you should get these investigations done to rule out any malignancy.
Other causes of heterogenous enlarged ovary are endometriosis and benign serous or mucinous adenoma.
Sinister signs of malignancy like free fluid in the peritoneal cavity, irregular echo texture of ovaries and liver enlargement are usually seen in ultrasound. They are absent in your case, and hence the ultrasound report do not mentions it.
Since these signs are absent, the chances of malignancy are very low, and that may be the probable reason of your late referral.
However, I suggest you to keep calm and be positive, despite the apprehension you are facing.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (1 hour later)

But isn't that the same heterogenous texture and irregular echo texture ? As I Have heterogenous texture to one ovary ? I'm now confused please help me understand thank you XXXX

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Not the same

Detailed Answer:
Hi dear,
Don't be confusing.
By irregular echo texture, I meant that the ovary containing septations, solid and cystic components together, irregular borders etc.
Whole ovary which has heterogeneous texture do not contain the above mentioned features.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (13 hours later)

Hello what does whole ovary in heterogenous texture mean please? Do you think i should have the c125 test now as my dr said it can give false readings if you have fibroids or endometriosis? I do have 1 small fibroid ? Thank you XXXXXXX

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
CA 125 should be done

Detailed Answer:
Hi dear,
Whole ovary enlarged and with heterogeneous texture means that the ovary is either filled with old blood ( as in endometriosis) or filled with tumour cells( benign or malignant).
In my opinion, CA 125 should be done.
It comes in false positive in large fibroids and extensive endometriosis.
You have a very small fibroid and no history of endometriosis.
Moreover, only CA 125 is not confirmatory, you should get a colour Doppler ultrasound to assess the blood flow to the ovaries, which is increased in malignancy.
Hope you found the answer helpful .
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (18 minutes later)

I have no history if endometriosis but have suffered with heavy long periods all my life,with clots and heavy bleeding for two days.i have tranexamic tablets to help.if there was was something in echo texture would the sonographer have see it and mentioned it on scan report?all my report said was enlarged ovary which appears to be heterogeneous in texture.why do I have two enlarged ovaries though is this common and maybe I have had this years and didnt know anything about it until I had the scan? Can you see endometriosis and endometrioms on a scan would she have picked this up ? Thank you XXXX

Answered by Dr. Deepti Verma (2 hours later)

Brief Answer:
Endometriosis not visible in ultrasound

Detailed Answer:
Hi dear,
Heavy blood flow during the periods can be due to endometriosis, but it is usually associated with severe pain during the periods and pain during intercourse.
Endometriosis is not visible in the ultrasound, however if endometrioma is present in the ovaries, it is visible as heterogenous enlarged ovaries due to the old clotted blood inside.
Enlarged ovaries is not normal for the female of your age group, and that is why I am stressing upon its further evaluation.
Hope you found the answer helpful.
Please do get back for further queries.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (25 minutes later)

Ok I will wait for my gynocologist referral which I will definitely attend.i do have pain when have sex especially if I am on top so hopefully that's all it is.i am torturing myself as to why it's not a urgent referral as you say it's not normal at my age to have enlarged ovaries.my dr will not do a c125 blood test as he said it may give a false positive reading and is not reliable as I have had heavy periods for years etc.he just said wait for referral.please explain again echo texture is different to heterogenous texture? as I've read and it all seems the same to me many thanks XXXX

Answered by Dr. Deepti Verma (13 minutes later)

Brief Answer:
Do not panic

Detailed Answer:
Hi dear,
Please do not panic and do not torture yourself.
I think I am not able to explain and convince you completely :(
Echotexture in ultrasound means the appearance of a particular organ and its contents in the ultrasound, it can be homogenous, heterogenous, cystic etc.
These are the various term given for the different echotextures seen in the ultrasound.
Pain during intercourse while deep penetration is more suggestive of endometriosis.
Please be calm and do not stress out yourself too much. You are more likely to have a benign pathology, however , it is a medical protocol, to rule out more serious diseases like malignancy before starting the treatment.
Hope this time I was more clear in my explanation.
Regards
Dr Deepti Verma

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. Chakravarthy Mazumdar