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What Does My Ultrasound Report Indicate?

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Posted on Fri, 14 Nov 2014
Question: 63, year old, G3P2 (irregular periods when young-normal before menapause). Had mimimal pinkish discharge at intervals; spots 1cm bleeding x 2. Normal Ultrasound with 2mm stripe but no endometrial tissue obtained with biopsy. Proceeded to LAVSH. That path report is as follows and has been sent from level 2 hospital to level 3 (UOI) for review:
Cervix: mild chronic inflammation
Endometrium: atypical proliferation
Myometrium: Leiomyomas with atypical parivascular cells, and extensive aenomyosis
Serosa: No diagnostic abnormality
Left ovary: focal serous papillary proliferation with clcifications including psammoma bodies, no definite stromal invasion identified
Right ovary: No tumor identified
Bilateral fallopian tubes: no tumor identified

two very well respected OBs (generalists) did surgery. They reported everything looked normal except she could identify a small fibroid. Procedure went smooth with complication. No dissection of nodes of washing r/t non-suspecious findings. She did comment that there was some scar tissue on the right side that looked like at one time I had some inflammation. I had a virgin abdomen. The only thing I can think of is years ago I had a bad fever and severe pain following having my tubes cleared and XXXXXXX seed oil infused r/t infertiity.

So does this sound like ovarian cancer or what..? Do I need follow-up with GynOnc? Should I also get another final diagnosis from Mayo when the first is received from University of Iowa?
doctor
Answered by Dr. Richa Agarwal (52 minutes later)
Brief Answer:
Yes! You should follow up with gynaecologist.

Detailed Answer:
Hi,

Thanks for writing to us about it.

I can understand your concern, though.

Yes, you should follow up with a gynecologist and wait for another report.( it is always more beneficial to take second opinion in these cases).

Your finding in left ovary can be viewed as a borderline ovarian cancer.

Meanwhile, you should go for the ovarian marker test as well.

Hope it is useful, feel free to ask more question.

Good luck.
Regards
Dr.Richa
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Richa Agarwal (4 hours later)
If a borderline ovarian cancer would I need a second surgery for additional samplying as nothing was collected in the first surgery because nothing looked suspicious.
Would the ovarian marker test to elevated r/t the previous surgery or it best just to get it as a baseline.

Thank you for your assistance in this matter.

And by followup you indeed mean a gyn-onc not a regular ob-gyn
doctor
Answered by Dr. Richa Agarwal (6 hours later)
Brief Answer:
Follow up with gynae- oncologist.

Detailed Answer:
Hi,

Nice to get word from you all again.

Yes, you can move for second surgery for additional sampling to rule out the ovarian cancer.

You should lead to ovarian marker test as a baseline investigation.

You should succeed with a gynae - oncologist for your symptoms.

Hope it is useful, feel free to discuss more.

Good luck.
Regards
Dr.Richa
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Richa Agarwal (9 hours later)
So in your opinion if this is read as a borderline ovarian cancer I should have other samples taken and what would those include. My ovarian marker I assume you mean CA125. Would that be elevated simply r/t the first surgery? What number would that need to be to be reassuring? Would you recommend the University of Iowa or Mayo Clinic in Minnesota?

Thank you so much; you seem very kind.
doctor
Answered by Dr. Richa Agarwal (3 hours later)
Brief Answer:
CA125 less than 35IU/ml is considered normal

Detailed Answer:
Hi,

Nice to get word from you all again.

Your sample includes biopsy tissue from both ovaries, Fallopian tubes and abdominal cavity and pelvic area. Abdominal fluid also be taken to look for cancer cells.

CA125 is not a specific marker for ovarian cancer, its level rises in other conditions and cancer also like fibroid (as in your example) and endometriosis and rectal, lung cancer.

Its level should be less than 35IU/ml, that is considered normal.

I think the Mayo clinic in Minnesota is a much better choice.

Hope it is found useful and enlightening to you.

Good day.
Regards
Dr.Richa
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. Raju A.T
doctor
Answered by
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Dr. Richa Agarwal

OB & GYN Specialist

Practicing since :1999

Answered : 4026 Questions

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What Does My Ultrasound Report Indicate?

Brief Answer: Yes! You should follow up with gynaecologist. Detailed Answer: Hi, Thanks for writing to us about it. I can understand your concern, though. Yes, you should follow up with a gynecologist and wait for another report.( it is always more beneficial to take second opinion in these cases). Your finding in left ovary can be viewed as a borderline ovarian cancer. Meanwhile, you should go for the ovarian marker test as well. Hope it is useful, feel free to ask more question. Good luck. Regards Dr.Richa