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What MRI Results Confirm Cancer And What Kind Of Hysterectomy Should Be Done For Ovarian Cancer?

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Posted on Sat, 28 Dec 2013
Question: I received my MRI results today, and will follow up with doctor tomorrow. "Suspicion of an approx. 1 cm mass in the right fundal endometrial region. Early arerial enhancement is seen within this mass and the myometrium is focally thinned to greater than 50% overlying the mass." I went in for an additional MRI due to this, and the second report said, "The additional sequences reveal restricted diffusion within the fundal region mass that involves and/or distorts the endometrial stripe, average central ADC value 830." Cancer? Is this how it is staged? I am supposed to get a hysterectomy due to family history of ovarian cancer (no cancer yet for me at age 47) in January. Should I get one earlier? Do I have cancer? If so, what stage would it be? What type of hysterectomy is recommended in this situation? Would I be a candidate for Da Vinci? Or should it be done "open"? Thank you so much.
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Answered by Dr. K. Harish (1 hour later)
Brief Answer: vigilant clinical evaluation and management has to be planned Detailed Answer: At the outset we have to understand that MRI is an imaging process. Hence the reports can suggest a particular area of abnormality which needs to be evaluated further. Here MRI has picked up a 1cm lesion. Since you have already had endometrial ablations, it would be difficult to make an exact diagnosis at this stage. You have to consult your Gynecologist who would be in a better position to evaluate you. You might require "fractional currettage" where in the endometrium would be biopsied. Again your gynecologist would be best to advise you on this. It is also possible that this may not be required. MRI cannot diagnose cancer. Your Gynecologist should be able to tell you / diagnose cancer or otherwise. If your gynecologist suggests hysterectomy, please go ahead. If it is diagnosed as cancer, the hysterectomy would be slightly different and other surgeries like nodal dissection etc may be added. There is no difference between open, laparoscopic and robotic (Da Vinci) regarding surgery. Long term oncologic outcomes are not available. The actual tissues removed in all are same. The cost, availability of the technology, comfort of the surgeon vary. You can undergo the procedure with any of the three options depending on your Gyn advice.
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. K. Harish

Oncologist, Surgical

Practicing since :1986

Answered : 59 Questions

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What MRI Results Confirm Cancer And What Kind Of Hysterectomy Should Be Done For Ovarian Cancer?

Brief Answer: vigilant clinical evaluation and management has to be planned Detailed Answer: At the outset we have to understand that MRI is an imaging process. Hence the reports can suggest a particular area of abnormality which needs to be evaluated further. Here MRI has picked up a 1cm lesion. Since you have already had endometrial ablations, it would be difficult to make an exact diagnosis at this stage. You have to consult your Gynecologist who would be in a better position to evaluate you. You might require "fractional currettage" where in the endometrium would be biopsied. Again your gynecologist would be best to advise you on this. It is also possible that this may not be required. MRI cannot diagnose cancer. Your Gynecologist should be able to tell you / diagnose cancer or otherwise. If your gynecologist suggests hysterectomy, please go ahead. If it is diagnosed as cancer, the hysterectomy would be slightly different and other surgeries like nodal dissection etc may be added. There is no difference between open, laparoscopic and robotic (Da Vinci) regarding surgery. Long term oncologic outcomes are not available. The actual tissues removed in all are same. The cost, availability of the technology, comfort of the surgeon vary. You can undergo the procedure with any of the three options depending on your Gyn advice.