Help with ultrasound results??/

Posted , 5 users are following.

Hi there-

I am new to this community, or this catagory, and if you are willing to assit with my question, I thank you in advance......

Last weekend I was taken to the ER with brown spotting between period, severe bloating, very bad back and lower abdomial cramps. An ultrasound was performed, and at the end of my stay- the doctor handed me the reulsts and said' You will be fine " and said go home, and lt your GP know.

The ultrasound report said- fundal portion of endometirum is hetergenous - 8 mm. A complex cyst was identifed on the right ovary- consstant with a invoulting follice. Left ovary could not be seen clearly. NO free fliud.

I did take this information to my GP and he said he would reffer me to a OBGYN- which will take 6 months.

My GP said when I asked him to explain these words, he replied with' its like milk......whilte milk is white, your uterus is now like chocolaye milk" ! Yes I am looking into getting a new GP and OBGYN- but the wait is long.

I am huge- I gained 40 pounds in under a year, my stomach looks 9 months pregnant, I have cramps still- almost a burning feeling on the inside, I am no longer spotting but my period is late by a week, my back is achy as is my tummy...........help?

I am 43-  3 children, history of lumps and bumps- Lipoma removed two months ago from postier of neck, 2 liopmas removed from breats, and 1 spindle cell, low grade 3 from thigh 12 years ago. Healthy otherwise other than these new systoms.

Thank you so much! 

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17 Replies

  • Posted

    Hi Lisa,

    You've come to the right place! First, breathe. I know it's a lot to take in.

    I went in for a general exam, only to be told I had a 26cm mass in my abdomen - which later was indentified to be a extremely large cyst they thought was on my right ovary. I'm only 24, with no history of this before.

    Like you, I felt bloated, and looked about 6 months pregnant. I would have trouble controlling my bladder a bit, like peeing when I sneezed, some fatique, but nothing I could have chalked up to a cyst. I thought I had just gained weight. With you saying you look 9 months pregnant, did they tell you the size of the cyst? I would imagine it is probably similiar in size to mine.

    6 months seems like an outrageos amount of time to wait, but I know that can be the case sometimes. I'm from Canada, and live in the US - so I paid more to have it done here, but I couldn't have waited to get it done in Canada, even thougn it would have been free. I'm not sure where you're located, but if I were you, I would shop around for other Gyno Oncologist Surgeons, read up, do your own research. When I got my CT results back, I asked to be referred to a well-respected hospital, and due to the size of mine, my GP marked it as urgent. I got my consult with one of their best Gyno Oncoligst Surgeons in the state within 2 days, and then my surgery was scheduled 12 days later. I am now 12 days post-surgery, recovering well, and all I have is a 3inch incision on my bikini line - they saved all my reproductive organs because it was not cancerous. They drained 6 litres of fluid and I lost 13 pounds.

    Your surgeon and their plan is probably one of the most important things, but also being active and not passive about your case. 

    Best of luck!

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    • Posted

      Just knowing you understand means the world to me! Thank you, thank you! I am living in calgary currently- and if you know anything of calgary- then you know there is not alot going on around these parts, though some would disagree and say there is smile

      I really apprechaite your advice, and  I am going to do just that being active about the case.

      May I ask how you are feeling? 13 pounds down- what does that feel like?

      So you feel having the surgery was the best thing for you to do? I would be quite alright if I needed to have it removed as well I believe- I suppose knowing there is something there that really should not be is where I am stuck in my thinking.

      And no- on the ultrasound there were no dimentions of the cysts size at all- odd I know.

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    • Posted

      Ah yes Calgary, cow-town! I'm originally from Vancouver.

      13 pounds down and I feel great! My stomach is so flat, this is probably the lightest I've been in a while and I finally have the motivation to start working out, tone up - all the things I was depressed about post-surgery because I thought I had just gained weight. I can breathe better, no more stomach aches. My cyst was 29cm tall so it was pressing on my diaphram as well.

      Yes I'm absolutely glad I did the surgery. If it's over 6cm, you usually need to have surgery to remove it anyways - at that point, depending on the cyt, it's not going to rupture on it's own. I had never had surgery before so I was scared, but it was a piece of cake. 

      So you've only had a ultrasound? No CT or MRI? I would take it that would be your next step and can provide you with more information.

      But yes, be very active and persistant if you need to be!

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    • Posted

      Hey you!

      13 pouds down! oh ghesh girl I have to admit- I am jealous wink I am so bloated! But soon enough??? I hope.........

      I have been calling very obgyn here in Calgary and I Am no further ahead.... The closest apt is 4 months away- but you know I am not giving up.....I am going to try and get this done with.......And no??? no ct or MRI???? They will do that do you think???????

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    • Posted

      That's part of the reason I had to do mine in the US. It was too big to wait much longer, even though I have lots of medical bills now my family is going to help me out.

      I would imagine they would want to do a CT or MRI because it might provide them with more information than an ultrasound, for example. But then again, my ultrasound gave me little information other than a "a large cystic mass over 24cm is present" versus the details I got from my CT.

      They'll probably want to run several pre-surgery bloodtests as well once you get in. I had 9 or so viles or blood taken, some were to test for cancer markers as a precaution.

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    • Posted

      Hi again !

      Is it too personal to ask how much the surgery was there ?

      I personally feel it is worth it - the cyst is gone and you are felling so much better ... To me you cannot place a price tag on Health .

      Maybe you would know but do these cysts ever come back once removed ?

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    • Posted

      Hi!

      No not at all.

      I haven't gotten all my bills yet but I can tell you what I've paid so far in relation to this cyst. This is with my crap insurance.

      $150 for initial office visit with GP

      $150 for Ultrasound

      $350 for CT scan

      $200 for pre-surgery consult

      I haven't gotten my bill for the actual surgery or hospitalization yet but I imagine it's a few thousand dollars. Mine was so big the only option I really had was to get it done in the US but I wish I could have gone to Canada where I'm from.

      As for them coming back, I think that varies person to person and the type of cyst. They told me it's always possible as long as you have your reproductive organs.

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    • Posted

      Lisa,

      The removed cyst does not come back but it is possible to have a recurrance.  Keep in mind we get a cyst every month due to the production of the egg in our cycle. 

      Sometimes the cysts do not get re-absorbed and something goes haywire and it continues to grow.  Or there is a genetic anomaly that causes the dermoid cysts.  It just depends but the recurrance rate is low so hopefully you are in the non-recurrance group.  smile

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  • Posted

    Lisa,

    You have been through it haven't you? :-(

    I had huge cysts on both ovaries. So large my bladder could not be found on ultrasound. Hence peeing every 20 min to an hour. Severe constipation and looked pregnant. All came on gradually but felt cut in the waist with regular clothes.

    Mine was all caused by endometriosis. Try to relax and continue to seek new Drs. So sick that the health system moves so slowly. Do men have to wait so long to be treated?

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    • Posted

      Thank you for your response......NO- men do not have to wait this long....I was just sharing above in the last post I made, the earliest I can get in- 4 months.....and I am calling everyone!!! May I ask- did you have surgery???? I do not know alot about your condition- does this conditions go away or? I hope you are doing ok
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    • Posted

      Lisa,

      Oh my goodness!!  I can't believe you have to wait 4 months.  That's just to see the Gynecologist right??  Then referral for surgery?  I just don't understand is there that bad of a Drs. shortage??  I women could have a pregnancy and deliver the baby before she ever saw a Dr.!

      I am SO sorry you are in such pain!  I fortunately did not have ovarian pain from mine but I don't know how women function having to wait so long to be seen. 

      I know it's not much but know you are not alone.  I am praying for you and feel free to drop a note whenever you need.  Hoping this goes quickly for you and you're back to yourself soon.  Till then stay strong and know the end is in sight. 

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  • Posted

    Lisa,

    Sorry, hit the send button by accident.

    You've had surgery before so you know the drill. This though has progressed over time and you may have forgotten what you felt like before this.

    You will feel SO much better once they are gone. They sap your strength and put pressure on other organs causing secondary symptoms.

    Abdominal surgery is more invasive and will set you back for a bit. But depending on type of surgery and how much needs to be removed you will feel so much better in a week or two.

    You do need to plan for approx. least 2 weeks of full downtime. Then significant improvement from then on. This will flex some depending on laparotomy or laproscopic surgery and how you heal.

    I was 49 when I had surgery. I chose not to stress too much because I knew surgery was a must. I wanted them OUT!

    The pain wasn't bad as long as I moved slowly. First week shuffling around the house. 2nd week started walking outside. After the first week walking was easier. The most difficult was the fatigue. Being a stomach sleeper, sleep was difficult until the incision healed.

    I was directly across from the nurses station so ear plugs would have been good for night time. The nurses were great though. I asked for little so they responded well when I did.

    Once home I was alone at my daughter's house during the day for 2 weeks. At 3 weeks started driving and moved back home. Returned to work at 6 weeks. Worked from home by phone and on line for those 6 weeks. Stressful and tiring.

    At 6 months I felt stronger but still fatigued. By 12 months I reached my new normal. Incision healed but sensitive if bumped. I had total hysterectomy so some of the symptoms had decreased but they don't tell you how draining surgical (cold turkey) menopause is. Hence, my recommendation to preserve your lady parts. Still get occassional twinges but that's all.

    I started taking Vitamin B complex 100 about 3 weeks in. Noticeable difference in about 2 weeks. Good for healing and red blood cell maintenance.

    Overall, I do not look back. I feel so much better even with the symptoms of menopause. Some gone, some better, some not. I lost 10+ lbs from surgery. Struggled with weight gain a few years later. In the last couple of years weight has been coming off with minor diet adjustments. Actually easier than when I was younger. Likely because I am more free to walk and be active. Less idle time, life is more precious.

    So find new Drs. you can trust and are commited to restoring your health. Make you a priority. Be kind to you and do not be shy to push for what you deserve/need to be healthy again.

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    • Posted

      ah- ok....so you did have surgery....

      yes- I have had many surgeries before- but not on the women parts.....this is where I become nervous......

      I will tell you one thing- this is the first month I am doubled over from craming with my monthy....I have neever experienced this before and holy smokes! 

      So your post also explains the fatigue. I am literlly napping everyday now for two hours. Iam very exhausted .....so tired......

      slowly you are feeling well again.....

      I truly apprechiate ths posts- I do not feel so alone right now- which was very scary at the beginning

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  • Posted

    I think your report says 'involuting' follicle (?),  

    involuting means 'shrinking, disappearing'.

    Our ovaries always produce cysts, have to in order to develope and release eggs. 

    After the fluid filled follicle cyst burst (ovulation), they become a luteal body (yellow looking thingy) that produces progesterone. Sometimes after ovulation, it bleeds into this follicle and can get 2-3cm big again due to blood in it (hemorrhagic luteal cyst).

    Blabla I am sure you know that all anyway.

    Now, when they write 'complex' cyst, it is not a homogenous purely liquid filled cyst (as they are mostly in follicle phase) black blob, complex means to see some white structure, which is often fibrin, a blood clot. 

    If you look under corpus luteum cyst wikipedia, you see a pic, fully functional benign, but complex looking cyst, a blob with a structure inside.

    Helpful is also, if you know (in hindsight once menstruation sets in and calculate backwards) if you were in follicle, ca ovulation or luteal phase at the time of ultrasound.

    The most important thing is missing: the size of your cyst

    3cm is often a good cut-off size for follicle and luteal cysts.

    If something worrying is seen even under 3cm, it is noted (if neoplasm or endometrioma suggestion). Ultrasound is always a guessing game, when it comes to complex cysts, comes down to appearance and experience and follow-ups.

    But sonographers have experience and seen 1000s.

    as to endometrium lining in uterus.

    Again this thickness depends on cycle timing.  Often knowing when last menstruation was, is not as helpful (since follicle phase can be highly variable time, but luteal phase is not, even in PCO not too variable), then counting backwards once menstruation sets in after ultrasound.

    If your at ultrasound mentioned last cycle fits into a 28 day calculation (once you get your mens), there is no need to let them know. If it was grossly over 30days, please let them know in case it changes the phase you were in at ultrasound timing.

    The endometrium is usually 6-8mm thick around ovulation (so about 14 days before your menstruation sets in, hence I urge to look backwards for correct interpretation of ultrasound results), it will be 10-16mm thick by the time of menstruation (in the luteal phase) and be 1-3mm once bled off and cycle starting again (follicle phase).

    So your thickness of endometrium layer is of no concern, not knowing your cycle at that point anyway.

    Heterogenous in contrary to homogenous is 'patchy', not one colour, not one shade of grey look, speckled small or big (can be different looks, we don't know, we don't have a pic here). It could be little bleeings within endometrium for benign (very early conception degeneration, inflammation) to not so benign reasons. 

    It needs to be checked again.

    Chocolate milk....oh, they love that expression for 'blood', but I would say: not well stirred chocolate milk to express the heterogenity.

    e.g. When you have an endometrioma in an ovary, they often call it 'chocolate cyst' since it is brown old blood upon cutting through it, bleeding again and again into same cyst. It must not be confused with a blood filled (hemorrhagic) functional luteal cyst.

    Seems they also use this 'chocolate' expression for uterus endometrium lining, when it is heterogenous and most likely due to some little bleedings within.biggrin

    Honeslty your doc should explain to you very well every point of the report that you don't understand and give an interpretation. He has you there, he can look at pics (digital I presume, they can always be ordered as a copy on CD or print for him/her if not online connected and for you too).

    It seems nothing to worry about at this point from your ultrasound report re ovaries and uterus.

    But yes, you will need a check up ultrasound to see: what the cyst is doing, if it resolved, and what the endometrium lining is doing, if it bled off, if it was back to homogenous.

    6 months though sounds an awfully long time for ultrasound check, if your obgyn does it right then at the spot or referrs again for ultrasound? (some do it themselves, some referr again - wait, wait)

    Any chance you can have an earlier ultrasound check up on its own before seeing the obgyn? 

    Were your kidneys also checked in ultrasound?

    Usually sate of the art once doing abdominal ultrasound anyway having pain.

    ALL THE BEST!

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    • Posted

      Extremly informative! Thank you!!!!!!!!!!!

      It was the word complex I was challenged with as when I tried to play doctor and research cysts- Simple was fliud, and complex had material. I simply could not wrap my head around what type I have. Your post explains so much! I am at a 4 month wait time now- and I am spotting- then bleeding- then spotting etc etc in between the periods. Infact as I was explaining in an earlier post, this is the first month of my menses where I am practically doubled over. Very painful this month. wow.

      When the ultrasound was performed, I had finished my menses one and a half weeks ago. I was bleeding and in a ton of pain- hense the ER visit. That was Sept 4. I am not quite on my time as today there is brown and darkish spotting- like before- but it has been due.

      Yes my kidneys were checked and they were perfect .

      And thank you for the chocolate milk defination as well.....I am being so sincere- I understand a bit more and I thank you.....

      thank you!

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    • Posted

      ?Oh, nothing to thank for, since all I can say...you need a check-up to see, how things develop/turn out;

      there are two things to be checked: the right ovarian cyst and heterogen fundus endometrium. Actually a third: the 'missing' left ovary.

      Wow, from 6 to 4 months down rolleyes....I can relate to that waiting, waiting. So, so frustrating.....did you ask the secretary to be put on the waiting list? You could let her know, that you were worried, that something was not right in first scan and was about an asap specialist check AND you were in pain.

      Can't your GP speed up the ultrasound check up?

      BTW also MRI can be done for cyst and uterus/endometrium/myometrium check. No way an ovary can hide there! 

      How should one wait so long with pain?

      Have you read about adneomyosis?

      It's harder to diagnose since it is not a solid (easily seen) fibroma or adenoma in the uterus muscle.

      Your result though said the 'fundal part of endometrium' (not myometrium) looked heterogen, but if endometrium was broken into muscle there and actually adenomyosis.....hm.  (implanted endometrium in muscle wall looks heterogeous and causes all kind of pain, bleeding)

      If endometrium lining itself was heterogenous, it needs to be confirmed and go from there (hysteroscopy, biopsy for endometrial histology assessment...) or if it was back to homogenous now as it should be and 'just' an inflammation/infection (endometritis). ?? Endometrial lining should not be heterogen in appearance, there are lots of explanations, but it needs to be checked.

      You were far off menstruation bleeding to explain the badly stirred chocolate milk endometrium appearance.

      Endometritis would need antibiotic treatment.....you had a blood test (the standard blood counts, inflammation markers...) done, right? They would be up in case of infection. You have no (low-grade) fever, right?

      You are not on some medications or taking herbs, that could influence the female hormones (being estrogen like) or coagulation, that could do something to bleeding? Was your thyroid hormone level checked?

      Sorry you are in so much pain, there is something not right and the possibilities are many.

      Don't be discouraged to go back to ER in case it get's bad again.

      You tried outside of ER to get checked, but there is so much waiting.....

      All, all the best!!!!!!

      I am so sorry to be unable to point a finger onto something or help.

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