Pain in lower left abdomen and mass in right ovary

[ZanesMommyJen]

I am a 39 year-old mother of one.  I had been having pain in my lower left abdomen, extreme exhaustion, an extra period on two occasions in the past several months.  I went yesterday for a USTV which indicated that my left ovary is fine and "the right ovary measures 3.7 x 2.1 x 2.9 cm with an echogenic mass with central hypoechogenicity overall measuring 2.1 x 1.8 x 2 cm. Its wall demonstrates color flow."  I went today for the ca-125 test and am awaiting these results.  I know from reading about the ca-125 that the results will be little more than a possible indicator of ovarian cancer.  I will have a follow-up appointment with the gyn in 10 days.  My question is, has anyone ever heard of having pain on the opposite side of where the mass is?  Also, I have a history of having an anal fissure which causes some bleeding during bowel movements.  I've noticed more blood and some bloody clots following bowel movements since meeting with my MD.  Could the increased blood and new clots be related to whatever is going on with my ovaries?  Incidently, I've had a fever off and on for over a week with sinus congestion (I doubt the fever is related at all).  At this point, I feel more curious than fearful.  Any input is appreciated.  Thank you.

[ZanesMommyJen]

Hi Kevin.  Thank you for taking the time to respond to my questions.  The CA-125 result was very low (within normal range).  I have yet to see the GYN (seeing her this week), but my MD ordered a CT Scan with contrast last week.  The radiologist who read it does not feel that I have a mass, but rather a "probable involuting follicle/hemorrhagic right ovarian cyst." Based on that information, I suspect the GYN will chose to do nothing and monitor.  I'm pleased with the results of the CT Scan, but don't fully trust them.  I continue to have intermittent abdominal pain and extreme fatigue.

I hope your wife is doing well.  Thank you again for responding.
-Jen

[kcd86]

Hi, I am an RN and my wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010. Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx). The test you describe CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS. Please keep in mind if and only if you have a dx of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing tumors as opposed to epitheal.
Based on your TV-sonogram report,  symptoms unfortunately with any type of suspected ovarian mass surgery will be the only way for the Dr's too make a definitive Dx. It is NOT recommended to biopsy any ovarian mass as it will rupture and seed the pelvis with cancer cells if that what it turns out to be.  Please make sure they drew your blood for the following blood tests,Inhibin A&B, CA125 and CEA so at the very least you have baseline blood work.
Since there is some suspicion based on your TV-sonogram I would immediately find a good GYN/Oncologist surgeon. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients.  This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal.
Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive and stay on top of your phycicians. Get copies of all your tests/results. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best
Kevin