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What Does My Ultrasound Report Indicate?

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Posted on Thu, 30 Oct 2014
Question: Hi, could you help me interpret this report? Left ovary contains a 22x16x13mm cyst with homogeneous low level echoes and a 31x27x30 with streaming low level echoes. No abnormal color flow detected. Radiologist thinks they may be endometiomas. I am 49 and currently taking tamoxifin for breast cancer prevention. I am contemplating a hysterectomy.
doctor
Answered by Dr. Indu Kumar (33 minutes later)
Brief Answer:
You are rightly advised for follow up scan.

Detailed Answer:
Hello XXXX

Findings are suggestive of complex left ovarian cyst most likely endometrioma.
Endometrioma is indicated by presence of echoes within the cysts.
It need clinical correlation and in majority of the cases it only require follow up scan and symptomatic treatment.
You are rightly advised for follow up scan.It can be managed by both medical or surgical removal.

However,it is also important to screen for malignancy.Tumour markers assay should be done.MRI scan can be done if needed.Though chances of malignancy is very less but it is important due to your age.

This condition doesn't require hysterectomy.However,it is important to know the findings of uterus.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Indu Kumar (10 minutes later)
Thanks for your reply. I have multiple fibroids in my uterus which are a symptomatic due to the tamoxifin. I do not get my period anymore. My gyn is overly cautious with me due to my family history of breast cancer. I have not had it.

I am a bit concerned that after my gyn read the report she questioned the diagnosis of endometria since I do not have a past diagnosis of endometriosis. That worried me.

Lastly, would these ultrasound findings indicate a more serious condition, like cancer?

I am a nervous wreck
One other thing, what us the difference between homogenous vs streaming low level echoes.

Thx again!
doctor
Answered by Dr. Indu Kumar (10 hours later)
Brief Answer:
Mostly it is not a serious condition.
Less chances of cancer.

Detailed Answer:
Hello XXXX

Hysterectomy may be considered for multiple fibroids,if family is completed. This is also important due to tamoxifen.

Complex cyst in left ovary need further evaluation. It may also be a infected cyst.
All possibilities including cancer(though chances are very less) should be excluded.

You don't worry. Most likely it is not a serious condition.
Echoes within the cyst may be stationary, moving, less in number or excessive depending upon many things like consistency etc. It is not important for diagnostic point of view.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Indu Kumar (7 hours later)
Thanks for your help. I really appreciate it. I wanted to run something by you although it probably does not have any significance. I was running about 6 weeks ago and had a bad fall. My whole left side was scraped up. When I first met with the radiologist she said I may have a bruise. She did not mention that this time but I wonder if that has anything to do with the blood in the cyst.

Also, dose low level echos mean just blood or could it mean other things such as septations/debris. Would that be mentioned in the report separtetly.

Also, the report does not mention Complex cyst but I assume that is what it is. I am assuming that from the report they are still considered to be cysts and not tumors. This is a bit confusing as Endometria's are described in the literature as tumors.

Thanks again, I really appreciate you helping me sort through all of the information. I feel I can make the best decision if I am comfortable with the topic.

You have been most helpful and I appreciate your quick responses.
doctor
Answered by Dr. Indu Kumar (3 hours later)
Brief Answer:
Not related to fall.

Detailed Answer:
Hello,

It is not related to history of fall.
If there is septations, it would had been mentioned in the report.

Endometrioma belongs to complex ovarian cyst group. Low level echoes may be blood, reactionary to infection etc.

You shouldn't be so worried. Things will be clear after full investigations. Most likely it is a benign finding.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
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. Ashwin Bhandari
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Does My Ultrasound Report Indicate?

Brief Answer: You are rightly advised for follow up scan. Detailed Answer: Hello XXXX Findings are suggestive of complex left ovarian cyst most likely endometrioma. Endometrioma is indicated by presence of echoes within the cysts. It need clinical correlation and in majority of the cases it only require follow up scan and symptomatic treatment. You are rightly advised for follow up scan.It can be managed by both medical or surgical removal. However,it is also important to screen for malignancy.Tumour markers assay should be done.MRI scan can be done if needed.Though chances of malignancy is very less but it is important due to your age. This condition doesn't require hysterectomy.However,it is important to know the findings of uterus. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX