Sabriste
08-06-2009, 03:47 PM
I was recently diagnosed with PCOS, and my doctor sent me to get a pelvic ultrasound. The ultrasound revealed a 14 cm cyst on my left ovary. My bloodwork had shown that I had an imbalance in my LH and FSH levels (my estrogen and progesterone levels were normal). I was sent to get a CT scan, and further bloodwork. The bloodwork and CT scan showed that the cyst was an endometrioma and that I also had endometriosis. I also found out that I have a small tumor on my pituitary gland causing increased levels of prolactin...for what that's worth.
My GYN did several pelvic exams over the next few weeks, and could feel the cyst on the left side, putting pressure on everything and all that stuff. She scheduled me for surgery, given the size of the cyst and the fact that it has been causing me a lot of pain (on the left side of my abdomen, I might add). As a final test, she sent me to get an MRI.
Now, when I went in for my pre-op today, she told me that the MRI showed that there is nothing but a 1 cm cyst on my left ovary, and that the problem is a 10 cm fibroid on the top of my uterus, towards the right.
What the heck?!? I mean, really? How can I go from having a 14 cm left ovarian cyst diagnosed by pelvic exams, an ultrasound, bloodwork and a CT scan, to having a 10 cm uterine fibroid to the right, which none of the other tests had detected? I've read that most fibroids occur in women in their late 30's and beyond...I'm 28. Is there any chance the MRI could be wrong? My GYN can't understand the change, and said she is only going to know for certain what is going on when she actually does the surgery.
Just wondering if anyone has any thoughts on this strange situation, or has had a similar changing diagnosis?
My GYN did several pelvic exams over the next few weeks, and could feel the cyst on the left side, putting pressure on everything and all that stuff. She scheduled me for surgery, given the size of the cyst and the fact that it has been causing me a lot of pain (on the left side of my abdomen, I might add). As a final test, she sent me to get an MRI.
Now, when I went in for my pre-op today, she told me that the MRI showed that there is nothing but a 1 cm cyst on my left ovary, and that the problem is a 10 cm fibroid on the top of my uterus, towards the right.
What the heck?!? I mean, really? How can I go from having a 14 cm left ovarian cyst diagnosed by pelvic exams, an ultrasound, bloodwork and a CT scan, to having a 10 cm uterine fibroid to the right, which none of the other tests had detected? I've read that most fibroids occur in women in their late 30's and beyond...I'm 28. Is there any chance the MRI could be wrong? My GYN can't understand the change, and said she is only going to know for certain what is going on when she actually does the surgery.
Just wondering if anyone has any thoughts on this strange situation, or has had a similar changing diagnosis?
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estria
08-07-2009, 08:38 AM
Sabriste,
I have a feeling that the ultrasound and the MRI were both visualizing the same thing ! The top of your uterus (assuming they mean outside) and your ovary area are around the same place. I know on the chart it looks obvious but in actual fact, everything is close together in there and your ovaries are near the top of your uterus. There is a possibility that the angle from where they were seeing things differed in each test and so the location on the report differed as a result. Whether it be 10 cms or 14 cms, this is still a large growth and it should definitely be taken out. The difference in dimensions may also be due to the different type of test done. There is a lot of variation when they are measuring these things and depending on the angle, the type of machine, the person doing the test etc.. these can all have an effect on the final result of the report. For cysts and growths of this nature, I would have a tendency to trust the ultrasound more than the MRI. It is supposed to be more of the gold standard for these types of things as it is better able to see the composition of the growth. The MRI can sometimes actually give too much information (!) which is difficult to interpret (kind of like finding a red scarf in a huge crowd of people).
The surgery will be the ultimate confirmation of what is there and where because once the surgeon is in there, there can be no doubt of what it is, a cyst or a fibroid and where it is located. If you want to put your mind at ease, you may consider popping in for a final ultrasound before surgery and seeing if this can make a definitive decision as to where the growth actually is. Sometimes ovarian cysts that are diagnosed on ultrasound will actually be located within the fallopian tube and not within the ovary. It is very difficult to actually visualize things sometimes, especially if the location is a bit unusual. You may consider having a transvaginal ultrasound instead of an external one as this will enable a closer look at the growth.
As for the 1 cm cyst that is on your ovary, this is most likely a normal functional cyst that we women get with ovulation every month. It is strange that you were diagnosed with PCOS and you don't have the standard necklace pattern of ovarian cysts that most women have. Have they considered that perhaps you DON'T have PCOS and the that the LH and FSH are out of whack because of the growth on your pituitary gland ? This would seem to make more sense to me. Hopefully they are tackling this other issue as well. An MRI in this part of the body would definitely be a good idea in order to see where the growth on the pituitary is actually located. Might they be able to shrink it without surgery ?
I am sure that everything will go well with the surgery. Hang in there and think about how relieved you will be after the procedure, knowing you don't have to think about ultrasounds or cysts or growths or all of that stuff and you can go back to living a normal life as before. Come back and tell us how things are progressing.
Regards,
Estria
I have a feeling that the ultrasound and the MRI were both visualizing the same thing ! The top of your uterus (assuming they mean outside) and your ovary area are around the same place. I know on the chart it looks obvious but in actual fact, everything is close together in there and your ovaries are near the top of your uterus. There is a possibility that the angle from where they were seeing things differed in each test and so the location on the report differed as a result. Whether it be 10 cms or 14 cms, this is still a large growth and it should definitely be taken out. The difference in dimensions may also be due to the different type of test done. There is a lot of variation when they are measuring these things and depending on the angle, the type of machine, the person doing the test etc.. these can all have an effect on the final result of the report. For cysts and growths of this nature, I would have a tendency to trust the ultrasound more than the MRI. It is supposed to be more of the gold standard for these types of things as it is better able to see the composition of the growth. The MRI can sometimes actually give too much information (!) which is difficult to interpret (kind of like finding a red scarf in a huge crowd of people).
The surgery will be the ultimate confirmation of what is there and where because once the surgeon is in there, there can be no doubt of what it is, a cyst or a fibroid and where it is located. If you want to put your mind at ease, you may consider popping in for a final ultrasound before surgery and seeing if this can make a definitive decision as to where the growth actually is. Sometimes ovarian cysts that are diagnosed on ultrasound will actually be located within the fallopian tube and not within the ovary. It is very difficult to actually visualize things sometimes, especially if the location is a bit unusual. You may consider having a transvaginal ultrasound instead of an external one as this will enable a closer look at the growth.
As for the 1 cm cyst that is on your ovary, this is most likely a normal functional cyst that we women get with ovulation every month. It is strange that you were diagnosed with PCOS and you don't have the standard necklace pattern of ovarian cysts that most women have. Have they considered that perhaps you DON'T have PCOS and the that the LH and FSH are out of whack because of the growth on your pituitary gland ? This would seem to make more sense to me. Hopefully they are tackling this other issue as well. An MRI in this part of the body would definitely be a good idea in order to see where the growth on the pituitary is actually located. Might they be able to shrink it without surgery ?
I am sure that everything will go well with the surgery. Hang in there and think about how relieved you will be after the procedure, knowing you don't have to think about ultrasounds or cysts or growths or all of that stuff and you can go back to living a normal life as before. Come back and tell us how things are progressing.
Regards,
Estria
estria
08-07-2009, 09:13 AM
Hey Sabriste,
Here's a thought. I know that some uterine fibroids can actually grow on a stalk outside of the uterus. If this is your case, this would account for the fibroid being mistaken for an ovarian cyst AND for its change in position (if it's on a stalk, there could be some movement, especially given its size). You may want to discuss this with your doctor as a possibility. This type of uterine fibroid is not uncommon and given your strange scan results, very likely.
Hope this helps.
Estria
Here's a thought. I know that some uterine fibroids can actually grow on a stalk outside of the uterus. If this is your case, this would account for the fibroid being mistaken for an ovarian cyst AND for its change in position (if it's on a stalk, there could be some movement, especially given its size). You may want to discuss this with your doctor as a possibility. This type of uterine fibroid is not uncommon and given your strange scan results, very likely.
Hope this helps.
Estria