SARAH: Just diagnosed with fibroids and 'adnexal mass' requiri...

January 10, 2004

:

The fact that " very little normal myometrium is seen " on your ultrasound is

probably consistent with the multiple small fibroids you do have. Your fibroids

are most likely intramural (situated in the myometrium). It could indicate

that there are many more small intramural fibroids present in the myometrium

that were simply not identified on your report. Taking over the " myometrial

terrain, " so to speak.

Imaging studies (including MRI, CT) are notoriously famous for underreporting

the actual number of fibroids in the uterus. I should know! All of my

ultrasounds, CT and MRI indicated I had 5 or so fibroids. But during

myomectomy, my

doctor removed a whopping 46 fibroids, ranging in size from 9cm down to 1cm.

The other possibility is that you have some adenomyosis (which could grow

into the myometrium).

As for your adnexal mass, I've had a very similar findings. Despite the

somewhat ominous wording on my U/S reports, it turned out to be an absolutely

benign ovarian cyst. Although on U/S it was found to be " complex. "

However, considering the dimensions of YOUR mass, I'd imagine you'll have to

get it removed (laporoscopically). Any kind of cyst, mass over 5 cm., no

matter how benign, is not likely to go away on its own.

Keep in touch and let us know what your GYN recommends.

Roma

In a message dated 1/10/2004 7:38:40 AM Eastern Standard Time,

sarahjmccoy_sj@... writes:

> Hi Folks,

> I have just today received the results of my ultrasound, which states

> the following:

>

> " The uterus is bulky and anteverted. Uterine dimensions 11.0 X 6.2 X

> 6.3cm. Multiple small fibroids are present numbering at least 4 and

> the larger on the left side of the fundus and in the left side of the

> body and both measuring 2.1cm. Very little normal myometrium seen.

> The endometrial echo is of normal thickness measuring 8mm.

>

> A large complex mass is demonstrated in the left adnexal region

> extending out of the pelvis. This mass has dimensions of 11.3 X 11.1

> X 10.8cm. It is of mixed solid echoes but fairly well defined with an

> apparent capsule. The appearance likely to be left ovarian in

> origin. Correlation with pelvic CT scan advised.

>

> COMMENT: Bulky fibroid uterus. Large complex left adnexal mass

> requiring further evaluation. "

>

> I understand that, since I am approaching menopause (or may have

> already begun, depending on whether the 'left adnexal mass' is

> responsible for recent changes or not), the fibroids are probably the

> least of my worries. But I'm wondering about the comment " Very

> little normal myometrium is seen. " What does that mean? Any help in

> translating this report would be greatly appreciated.

>

> Thanks!

>

January 10, 2004

Just a word about Roma's comment regarding MRI - MRI's are usually very

accurate in diagnosing fibroids. However, the films need to be interpreted

by someone interested in and knowledgeable about fibroids. I look at all my

patient's MRI films and am surprised at the incomplete reporting often done

by some radiologists. Often the words " multiple fibroids " appear without

any information as to size, position, number, etc. A good radiologist

should report all this information for every fibroid, and a good

gynecologist should either look at the films themselves or review them with

the radiologist. I agree that CT scans are not a good way to see fibroids.

Bill , MD

SARAH: Just diagnosed with fibroids and 'adnexal

mass' requiri...

: