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What Does My CT Scan Report Indicate?
Question: diagnosed with sarc dec 2016 via mediastinoscopy and biopsy. Prior to biopsy had several imaging tests done in nov/dec 2016. CTS and Pet/CT. the pet scan lit up on mediastinal nodes and in left ovary area . I followed up with gyn onc for the left ovary area. Sono was normal. Had a CT scan in Dec 2016 of pelvis abdomen after PET which radiologist stated uterine mass most likely a leoimyoma was present. GYN/onc then did an MRI in dec 2016 which radiologist wrote I report confirmed a subserosal pedunculated degenerating fibroma appx 2 cm in size. Apparently I had had this fibroid from 2014 as it was seen by the radiologist on the old cts from 2014 and 2015 though no other radiologist ever made note of this in prior reports . In 2014 it was 1.0 cm , Aug 2015 2.0 and Dec 2016 2.5 cm. The gyn wanted me to have a follow up MRI in March 2017 to check on size and determine next step.
I.had the mri with contrast of pelvis today and was notified that it has not changed in size from3 months ago. I will be meeting later in week with the gyn onc to discuss treatment or next step.
my regular gyn thinks this is overkill and that fibroid does not need to be treated if it isn't causing any issues. She had wanted me to just get a repeat sono in six months after the MRI from Dec 2016.
My question: I have no symptoms or pain with this fibroid. I'm asymptomatic. I would have not known it is there until the pet/ct , mri etc. were donr. The gyn onc said it could might not need treatment but she seems to be more leaning to removal of the fibroid or had suggested a total hysterectomy .
I'm 44 and never had children and most likely will not, but I'm not really keen on a hysterectomy especially with the long recovery period. Also the risks involved with it as it could damage the bladder etc. concern me.
I am on bcp presently, not too excited at the idea of going into menopause which might happen after hysterectomy even if I keep my ovaries. Is a myomectomy or hysterectomy necessary if I'm not having any issues with the fibroid even though it's a cm larger from 2014? Does the fact that it is degenerating something bad that it needs to be treated? Or can I continue watchful waiting for now?
I.had the mri with contrast of pelvis today and was notified that it has not changed in size from3 months ago. I will be meeting later in week with the gyn onc to discuss treatment or next step.
my regular gyn thinks this is overkill and that fibroid does not need to be treated if it isn't causing any issues. She had wanted me to just get a repeat sono in six months after the MRI from Dec 2016.
My question: I have no symptoms or pain with this fibroid. I'm asymptomatic. I would have not known it is there until the pet/ct , mri etc. were donr. The gyn onc said it could might not need treatment but she seems to be more leaning to removal of the fibroid or had suggested a total hysterectomy .
I'm 44 and never had children and most likely will not, but I'm not really keen on a hysterectomy especially with the long recovery period. Also the risks involved with it as it could damage the bladder etc. concern me.
I am on bcp presently, not too excited at the idea of going into menopause which might happen after hysterectomy even if I keep my ovaries. Is a myomectomy or hysterectomy necessary if I'm not having any issues with the fibroid even though it's a cm larger from 2014? Does the fact that it is degenerating something bad that it needs to be treated? Or can I continue watchful waiting for now?
Brief Answer:
surgery not recommended.
Detailed Answer:
Hello,
Thanks for the query,
With international guidelines, if the fibroid is asymptomatic and not causing any bladder or bowel pressure symptoms or any disruption of menses in terms of heavy bleeding ( menorrhagia) or severe dysmenorrhoea( pain during menses) and also not causing any problem with the woman's day to day life , then it is not recommended to remove it at all.
Asymptomatic fibroid is not an indication for surgery. I believe 6 monthly follow up in your case would be the best.
Regards
surgery not recommended.
Detailed Answer:
Hello,
Thanks for the query,
With international guidelines, if the fibroid is asymptomatic and not causing any bladder or bowel pressure symptoms or any disruption of menses in terms of heavy bleeding ( menorrhagia) or severe dysmenorrhoea( pain during menses) and also not causing any problem with the woman's day to day life , then it is not recommended to remove it at all.
Asymptomatic fibroid is not an indication for surgery. I believe 6 monthly follow up in your case would be the best.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor.
Could I ask does the fact that is a degenerating fibroud of any importance? Or does that not make any difference as to treatment.
Could I ask does the fact that is a degenerating fibroud of any importance? Or does that not make any difference as to treatment.
Brief Answer:
answered
Detailed Answer:
Hello,
you haven't mentioned the size of the fibroid and its location on uterus , but nevertheless degeneration of fibroid is a long term phenomenon and almost never free of symptoms especially pain, so at present with no degeneration having set in, the course of action remains conservative and hence follow up is advised.
Regards
answered
Detailed Answer:
Hello,
you haven't mentioned the size of the fibroid and its location on uterus , but nevertheless degeneration of fibroid is a long term phenomenon and almost never free of symptoms especially pain, so at present with no degeneration having set in, the course of action remains conservative and hence follow up is advised.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi Dr. here is the radiologist report from Dec 2016 . I copied the sentence whete it does state it is a degenerating fibroud. 2.2 cm subserosal left uterine fibroid. same size on yesterday's mri. it hasn't gotten bigger in 3 months. I have not had any pain but i is degenerating. please see below description from radiologist report o dec 2016. thank you
2.2 cm subserosal left
fundal uterine mass with imaging characteristics compatible with a
degenerating subserosal fibroid. FDG uptake has been reported with
pelvic fibroids. As stated in the prior CT report, this mass has
increased from 2014 where it measured 1.1 cm. In a patient of this
age group, this increase in size is nonspecific. No enlarged pelvic
lymph nodes are visualized and there is no free fluid.
2.2 cm subserosal left
fundal uterine mass with imaging characteristics compatible with a
degenerating subserosal fibroid. FDG uptake has been reported with
pelvic fibroids. As stated in the prior CT report, this mass has
increased from 2014 where it measured 1.1 cm. In a patient of this
age group, this increase in size is nonspecific. No enlarged pelvic
lymph nodes are visualized and there is no free fluid.
Brief Answer:
answered
Detailed Answer:
Hello,
When the fibroid is degenerating, pain is the most common symptom. The process of degeneration usually occurs when the fibroid grows so large that the blood vessels “feeding” the fibroid can no longer supply it with oxygen and nutrients. The pain of a degenerating fibroid is often localized at the site of the fibroid and can last up to two weeks.
Another type of degeneration of the fibroid, however, is known as necrobiosis and typically occurs during pregnancy. In addition to symptoms of pelvic pain, necrobiosis may cause a fever and a blood lab may indicate an elevation of white blood cells. Not as often, but still likely during degeneration, a patient may witness bleeding.
As in your case there is no pain or any other symptom, there is no apparent need for any intervention for a small sub serous fibroid. The chances of fibroid turning into malignancy is rare and only 1% and it happens when the fibroid is growing which is not the case with you. So just relax.
Regards
answered
Detailed Answer:
Hello,
When the fibroid is degenerating, pain is the most common symptom. The process of degeneration usually occurs when the fibroid grows so large that the blood vessels “feeding” the fibroid can no longer supply it with oxygen and nutrients. The pain of a degenerating fibroid is often localized at the site of the fibroid and can last up to two weeks.
Another type of degeneration of the fibroid, however, is known as necrobiosis and typically occurs during pregnancy. In addition to symptoms of pelvic pain, necrobiosis may cause a fever and a blood lab may indicate an elevation of white blood cells. Not as often, but still likely during degeneration, a patient may witness bleeding.
As in your case there is no pain or any other symptom, there is no apparent need for any intervention for a small sub serous fibroid. The chances of fibroid turning into malignancy is rare and only 1% and it happens when the fibroid is growing which is not the case with you. So just relax.
Regards
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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