Palpable mass not seen on ultrasound

CanaryBird

Hello to all. Couple of days ago my Obgyn did physical and was able to feel a mass in the lower part of my belly, both outside and internally. I was sent to US the next day and she called back saying it came back normal. It was a big relief to know this initially. But then she said "she was surprised" to find out they did not see what she was able to touch with her own hands. This is unlikely to disappear for 24 hours. The question is: can a palpable mass be missed on US? Is this possible at all?  Thanks & take care.

CanaryBird

UPDATE: Requested a copy of the US report and it does in fact say about some findings, my Obgyn did not tell me. It says I have ascites (fluid in the pelvis) and a mass "with debris inside" measuring 4 cm. I am floored. How it could be?!

Flowergirl

Oh @CanaryBird - I am so sorry you are having these issues and had to deal with all that. Yes, please insist on an answer, explanation or a second opinion. 

Flowergirl

Also, I am guessing the US you are referring to is ultrasound... did you have a transvaginal ultrasound? and can you request a CT Scan as well... I hope this information helps you. 

CanaryBird

Flowergirl said:

Also, I am guessing the US you are referring to is ultrasound... did you have a transvaginal ultrasound? and can you request a CT Scan as well... I hope this information helps you. 

Oh, yes, this is ultrasound. And I have had a transvaginal one, you're right. I am anticipating a surgery to remove my ovaries (I hope) within few months. Before that, they unlikely to provide any tests to me. 

amyc

I am not sure this will help, but I had a  transvaginal ultrasound at the beginning of September.  My GP  repeated 3 times there was no sign of recurrence (I didn't believe him the first 2).  I had a CT scan October 25 that showed 2 significant masses.One was 12 cm about the size of a large orange.  I would strongly recommend you push for a CT scan.  If this is cancer it is very important, it is caught ASAP. Don't wait.  

CanaryBird

Amyc, thank you... You message made me write down "ask for CT!" in my questions list I prepare for my appointment with an oncologist. You are so right, by the end of the day it's all common sense: if this is touchable and palpable, why on Earth it does not show on US! 
Were your massed biopsied and what did the doctors tell you it can be?

Flowergirl

Thank you for sharing @amyc ... yes, more info and details can be found here: 
http://ovariancanada.org/about-ovarian-cancer/detection 

CurlyHair

@CanaryBird I wanted to comment that I have heard of women getting both the transvaginal ultrasound and the external abdominal ultrasound at the same time so that I assume they can see higher up in the abdomen.  The transvaginal only goes so high.  This might be another option to suggest to your doctor if the are not enamoured with at CT scan.  

amyc

@CanaryBird please check out the link from @Flowergirl. The only definitive way to determine if someone has ovarian cancer is to examine tissue that has been removed through surgery or a biopsy. If a doctor suspects ovarian cancer, you should be referred to a gynecologic oncologist for surgery (laparotomy) that will help the doctor identify the mass and determine whether it is malignant or benign (not cancerous).

AlbertaKat

It’s important to note that standard medical protocol is to wait and see if a newly diagnosed ovarian cyst resolves itself in 8-12 weeks, unless it’s over 5cm.  Sadly the attitude is that since it’s such a low probability that it’s cancer, this protocol works for 90% of the population.
My request to be referred to a gyn-Onc was refused.  I was told that until I have proof with a second ultrasound that that the mass is growing, no oncologist will agree to see me.

terrylee

I had a transvaginal ultrasound at the end of September which was normal and over the last month I've had pressure in my right (most of the time lower) abdomen off and on. It's not painful but it has me a bit worried. Luckily my 6 month check up is in 2 weeks so I'll address it then. 

CanaryBird

terrylee I wish it's nothing serious in your case. As it was suggested above, a CT scan may be reasonable to request

MarilynOCC

Hi @CanaryBird You have received some great feedback from @Flowergirl @amyc @CurlyHair @AlbertaKat @terrylee.  I do have a couple of questions for you.  You mention that you expect to have your ovaries removed in a few months - is there a reason for this?  You also mention that you are prepping for an appointment with an oncologist.  Do you have one booked or are you thinking this may be something down the road?

Have you discussed with your doctor the results of the ultrasound that you saw when you read the report - fluid in the abdomen and mass?  If not, you may want to consider booking another appointment to discuss this and ask the doctor what the next steps are for further investigation.  Tell them of your concerns.  Perhaps they may want to repeat the ultrasound a month after the first one, or you can ask about a CT scan. Maybe there other things that the doctor might suggest.  

Do you feel confident in going back to the doctor on your own?  Perhaps taking someone with you for moral support is something to consider.  Let us know how you are doing!

amyc

Taking someone to your doctor appointment is always a great idea.  

CanaryBird

Marilyn said:

I do have a couple of questions for you.  You mention that you expect to have your ovaries removed in a few months - is there a reason for this?  You also mention that you are prepping for an appointment with an oncologist.  Do you have one booked or are you thinking this may be something down the road?

Hi Marilyn. As I have mentioned before, I am BRCA1 positive, with a family history of cancer at young age. This is the reason I am followed by Hereditary Cancer Program. Besides prophylactic surgery I will have annual breast MRIs and some other tests because I am a heart patient as well.
I have a booked appointment with a surgeon oncologist in a few days to have a detailed conversation about the surgery, should it be tubes, ovaries or both removed. I plan to discuss my ultrasound and symptoms with her then. For sure, I will ask for CT, as some ladies here suggested.
It's totally okay for me to go for doctors appointments by myself. Seems I don't have any major stress related to my BRCA diagnosis, mainly because a tremendous support from my family, friends and you guys here. Thank you for that. Please take care.

amyc

Hi @CanaryBird I am so glad to hear you are followed by the Hereditary Cancer Program. Is removing the mass during the surgery on the table?  My gynecologic oncologist told me, they sometimes find the beginning of cancer in the fallopian tubes when there are removed. She also highly recommended taking out the ovaries if you are done having children. ( I am way past that but have family history and many female relatives).   It sounds like you are very proactive, have a great medical team and lot of support.  Please keep us updated. You are in my thoughts and prayers.  

CanaryBird

Hi Amyc. Yes, they basically told me the same. There are some subtle chances of incidental findings during the surgery. About the ovaries removal: it's a bit complicated matter in my case, as I also have a heart condition and my cardiologist is concerned that premature menopause could make it worse. But I hope they will arrange some kind of conference with my cardio to have a discussion. 
Thank you so much for your supportive words. I will update soon here. Please take care & all my best.

CanaryBird

Hay all. I hope everyone is okay. This is an update from my appointment which was yesterday. The surgeon was able to feel the mass herself and referred me to the gyn.oncologist. Additionally as some ladies suggested here, I have asked for a CT scan and I will get it. Now is just a waiting game. I hope I won't have to wait long. Please take my big thank you all for your ideas and response. 

Flowergirl

Hello @CanaryBird... thank you for the update and glad you got that referral...fingers crossed for the CT & that all goes well. 

MarilynOCC

Hi @CanaryBird.  Thanks for the update!  So good that you got the immediate referral to the gyne oncologist and the CT is ordered.  It still doesn't mean it is cancer, but you are doing all the right things and being seen by the right people which is great!  Hopefully, you won't have to wait too long for the tests, appointment and consult with your cardiologist. If the waiting gets hard, there is always someone here for you to talk to   

CanaryBird

Thanks much ladies! I was informed that my scan is booked in January. I have a question: does 2 months wait for CT scan seem a bit long or normal, given my symptoms of bloating, severe weight loss without try and this "palpable" mass? I also have bad constipation (laxatives do not work) and blood in stool occasionally. 

CanaryBird

So sad no one replied :-( I have to make a decision whether I go to a private clinic for a CT or better wait for 2 months. Please, express your opinions, they are highly needed for me. Thank you.

CurlyHair

Hello @CanaryBird.  2 months does seem a bit long to wait.  It depends on where you live though I think.  If you are in a big city they do sometimes run them all night so you can go sooner.  I am going for one at 8pm in Toronto but I had to wait one month.  What does your doctor say?  If your doctor is not too concerned about the wait that is a good sign.  I always say if you are not feeling well then just walk into your ER and do not wait.  That is what I have done in the past. 

CurlyHair

I forgot to mention to keep in mind that you could go for a CT scan tomorrow and that is not going to pressure your doctor into doing anything.  It is up to your doctor to decide the treatment schedule.  Not you.  I know it is frustrating but try to ask your doctor questions to give you peace of mind a bit.  Not putting money out of pocket for a CT scan.  

Flowergirl

Hi @CanaryBird - agreed with @CurlyHair.. it is hard to advise you, you will need to do what is best for you ... and yes, it depends on your province and your doctor.  I agree with to ask your doctor questions to give you peace of mind a bit... is he/she concerned and is it considered urgent.  Not sure if you can request to be on a wait list or would it make a difference if the requisition for the CT was sent to another facility.  
I also looked back at the chat and it seems you had a transvaginal ultra sound as well... did you also have the CA125 blood test? ...  perhaps you could discuss all of these with the physician to determine or increase the urgency of the CT.
And yes, for certain, if you are really feeling unwell and in pain please do seek the medical attention of the ER.
Wishing you the best and hope this helps. 

terrylee

If going to a private CT clinic is something that's is financially possible for you and you feel like it will give you some peace of mind (as opposed to waiting, stressing out, wondering what if for a few months) then maybe it's something to consider. 

MarilynOCC

@CanaryBird.  You have received some good feedback from the other members: asking about a wait list for the CT; talking to the doctor again and expressing your concerns based on your symptoms; asking the doctor about waiting or going to a private clinic; going to the ER; getting a CA125 if you haven't already.  These are all viable options for you and I understand your concern about waiting 2 months based on the symptoms you have.  As @Flowergirl has said, you will need to make the decision that you feel is right for you.  Have you made a decision yet?  

I am happy to talk to you on the phone if that is something that you think would be helpful.
1-877-413-7970 x231

Thinking of you!

CanaryBird

Thank you dear @CurlyHair , @Flowergirl , @terrylee & @Marilyn ! I really appreciate your comments & suggestions. My family doctor suggested to proceed with a private pay scan, because he was not able to suggest any other way to get it done sooner. He said my symptoms are concerning and it could be reasonable to make sure they do not miss any pathology asap. I have just came back from a CT scan (paid privately) and now wait. They gave me a CD disc with images but I do not understand them. I hope it's normal though. My family doctor will get a report next week. I am still bloated and constipated. But hope for the best. I will update when know the results. Take care all!

Flowergirl

Hi @CanaryBird.. I am glad you were able to get your plan in place... will be hoping the best for you for sure.

CanaryBird

Hi all. My CT scan results are back. My family doctor requested an urgent appointment to discuss lesions found in my uterus an liver. I hope it's nothing dangerous. Hugs to all.