Dr. Patil Pratik Pramod
Medical oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My mom, who is 70-years-old underwent a CAT scan after experiencing stomach pain a week back; a mass of around three centimeters was discovered on the ovary. Following this, she also underwent a transvaginal ultrasound. The doctor identified a tumor next to the ovary and not on it, so he did not think it was not ovarian cancer. He requested taking an MRI. He said that the tumor looked consistent and was 2.9 cm in size. He was not sure if it was cancerous or non-cancerous. Also, she has a history of estrogen-positive breast cancer from when she was 45-years-old and did not have a BRCA gene. I have attached the MRI and ultrasound reports. Could you please read through the ultrasound report and explain it to me?
Hello,
Welcome to icliniq.com.
I have read through the report you have attached (attachment removed to protect the patient's privacy).
1) It looks like a tumor adjacent to the ovary and an adnexal mass (a growth near the ovaries, uterus, fallopian tube, and the tissues connecting them) which usually could be malignant in this age group.
2) An MRI (magnetic resonance imaging) is done to differentiate if the tumor is benign or malignant, confirm the type of tumor, and check if it has spread to any other part, as that will change the management. Taking an MRI is very important.
3) Other than taking an MRI, a few blood tests should be done to check if it is a benign or malignant tumor.
4) Please discuss with your doctor regarding CA 125 (cancer antigen 125 is a blood test that measures the amount of cancer antigen in your blood) that could help diagnose the condition better.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for the reply.
She got the CA 125 test and is waiting on the results. The doctor said the mass looked consistent as the size is small (2.9 cms) and has a good blood flow. Considering her age, please give your opinion on the chances of it being benign? What kind of cancer do you think it is? Is it treatable? Also, if it spreads to other places, could the CAT scan have captured it?
Hello,
Welcome back to icliniq.com.
Considering her history of breast cancer, the chances of the mass being malignant is high. If cancer had spread to other places, the CAT (computed tomography) scan would have captured it. Still, MRI is a better investigation to look for soft tissue masses. If it is malignant, then this type of mass could be from ovarian cancer. Even then, it can be easily treated with simple surgery as it has not spread anywhere else. Please do not worry and stay assured.
Revert in case of further queries.
Patient's Query
Hi doctor,
Thank you for the reply.
The gynecologist mentioned that the blood flow looked good. Initially, he said that he was unsure if it was cancerous or not; he said the mass was detached from the ovary, which is why he did not think it was ovarian cancer. The CAT scan did not pick up on anything else. Also, she took tablet Tamoxifen 20 mg for five years after her stage zero estrogen-positive breast cancer. Could you please give your opinion on the following; Is having good blood flow a good sign? Do you think the mass has metastasized from somewhere else? Is it possible that it is a stand-alone adnexal mass?
Hello,
Welcome back to icliniq.com.
1) If the blood flow is good and consistent, it should probably be benign. A malignant mass will have a high blood flow and will be a non-persistent one. PI (pulsatility index) and RI (resistive index) indexes on the scan will tell if it is benign or malignant. I suspect it could just be a lipoma (fat mass or lump).
2) I suggest you keep getting her sonogram every month to see the size and blood flow of that mass. If for three months it is the same, it should be definitely benign.
Patient's Query
Hello doctor,
Thank you for the reply.
I have attached the recently taken MRI report. Please guide me on what the report says.
Hello,
Welcome back to icliniq.com.
I suggest you keep the mass under close observation by taking a sonogram every month.
Revert back in case of further queries.
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Medical oncology
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