Palpable mass not seen on ultrasound

edited November 10 in Just want to talk
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.

Comments

  • 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?!
  • 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. 

  • 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. 
  • 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. 
  • 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.  
  • 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?
  • Thank you for sharing @amyc ... yes, more info and details can be found here: 
    http://ovariancanada.org/about-ovarian-cancer/detection 
  • @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.  
  • @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).
  • 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.
  • 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. 
  • terrylee I wish it's nothing serious in your case. As it was suggested above, a CT scan may be reasonable to request
  • 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!
  • Taking someone to your doctor appointment is always a great idea.  

  • 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.
  • amycamyc
    edited November 17
    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.  
  • 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.
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