Cervical Cancer? Need Diagnosis

Hi, You have had a subtotal hysterectomy in 2005 and a left sided oophorectomy in 2007. It would be helpful to know the indication for the hysterectomy and the oophorectomy. You have not specified those. The tissues removed during the surgeries would have been subjected to a pathological assessment. It would be helpful if you provide those details too. The left side oophorectomy would presumably have been done for an ovarian mass or cyst. The histopathology report on the ovarian tissue would provide the details regarding the nature of the lesion. Currently, you have multiple lesions in the cervical remnant and the right ovary. The brownish vaginal discharge is most likely due to the mass in the cervial stump. Red blood in the stools indicates bleeding arising from the rectum, anal canal or lower part of the large intestine. The low back pain radiating to the leg can be caused by the cervical mass. Your dizziness can be due to anemia caused by the prolonged bleeding. Multiple bruises over the body suggest a problem with blood clotting. Occassional difficulty in breathing may be related to the anemia but can have many other causes. You need to undergo a thorough medical examination and further investigations which would include a gynecological checkup, a proctosigmoidoscopy which is an endoscopic evaluation of the anal canal, rectum and lower large bowel, complete blood counts, some biochemical tests to evaluate the liver and renal status, a chest radiograph, ECG and a CT scan and MRI of the pelvis. A diagnosis of cancer can only be established or ruled out by taking a biopsy or an FNAC from the suspicious mass. It is important that you do not delay your examination and investigations but please do not panic. The diagnosis can be established once these preliminary investigations are done and then the treatment options and prognosis can be discussed. All the best and God Bless!

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Wed 06, May 2009 11:17pm

Hi, thank you very much for having time to answer me. Im reall am so greatful from the bottom of my heart. you have ask me to provide the Histopathology report of the overy and the pathological assesment of the hysterectomy. I just want warn you 1st of the pathology report that we think is not truthful, unfortunately we were surprise to found out that the pathology was done in a mental institution very far from our place and the doctor herself that had done the procedure took it there (hosp. where the procedure was done has a lab for that). june 14,2005 in the evening I bleed a little heavy, me not knowing that my contraceptive I was taking(depo-proveda) will cause irregular menstration, & that sometimes heavy or very little, bbut my husband became concerned(not knowing that it will really be like that) took me the following day to my OB. When i arrived there and told her about the bleeding w/out any pregnancy test done she told me that its eptopic pregnancy and needs raspa(cleaning, not surgery) but 1st I argued that i cannot be pregnant because of depo-proveda which was on the 2nd month. anyway because that was her order i went to hosp. to get raspa, they did not even gave me general anesthesia just gave me regional. then she told me that she has to measure my uterus then thats the time all of them panic i had severe bleeding that she even opened me up without anesthesia in my abdomen. I woke up in the ICU. I learned I had cardiac arrest, I had 11 bags of blood transfusion, my platelets went so down they need to fix my bladder & they did total hysterectomy. I ask what caused all this PLACENTA PREVIA ACCRETA.I had 2 catheters and went home still with one. then afetr 4 mnths my lower right started to have pain, she just told me its gas pain. But my pain gets more severe so I reapetredly insisted her to have an ultrasound that was october of 2005 where they saw that my 2 overies has a cysts. The cysts in my right overy was bigger than my cyst in the left that on jan.2007 the left ovary twisted and ruptured. I were thinking that why did she still had not remove the other overy that it may cause also twist and rupture, but she explained that I would age faster (I was 23 that time). But after a few weeks the pain came back & every I kept on complaining to her & to give me explaination of whats causing it. She always just say gas pain so we decided to go to the advance city of my country (we live in a province) and it was also the time i had my 1st siezure. when i went already to manila there i found out that only a subtotal hysterectomy was done, and i was diagnose of epelepsy tonic clonic siezure (now controlled). now only my neurologist accepted me so my siezure was controlled but when we go to an ob- gyn they do not want to accept me because of so many reasons. the ultrasound reports that i told you, I was the only one who decided to have it done. Thats why i am asking for your help. I am in so my pain, our lives is never been desame. we are already spending a lot just to have treatment. I hope you can help me. I went to my friends ob-gyn & pleaded her to just give me explaination and she have me go to an oncologist after reading all my results.Ill send you in my histopath and pathology result in a little while just copying it. again my family and I thank you

Thu 07, May 2009 12:20am

HISTOPATHOLOGY Specimen: Left Ovary and Fallopian tube PathologicDiagnosis: Left Ovary: SEROUS CYST WITH HEMORRAGE AND FOCAL AREAS OF INFARCTION Left Fallopian Tube: CONGESTION GROSS AND MICROSCOPIC FINDINGS: The specimen consist of a cystic ovary labeled left and measuring 9.0x8.0x4.0cm in its collapsed state. Sections show a unilocular cyst containing clear serous fluid. The cyst wall measures 0.1 to 0.2 cm in thickness. No solid areas are noted. The fallopian tube measures 6x0.5x0.5cm. Representative sections taken Microscopic of disclose ovarian cyst lined by a layer of low cuboidal to flattened cells. The cyst wall is fibrocollagenous. Focal areas of infraction and hemorrhages are noted. The fallopian tube shows moderate congestion. Surgical Pathologigy Report Clinical Impression: Placenta percreta Specimen: Uterus Procedure TAH Gross Description The specimen submitted consist of a uterus with detached lower uterine segment. The uterine corpus measures 7.0x8.0x5.5cm and appears brownish and ovoid. Cut sections reveal a 3.0cm thick myometrium and a pinkish red endometrial layer. Three detached fragments are also submitted. The first appears grayish, irregular, and doughy, measuring 4.0x3.0x2.5cm.RSEB7 Microscpic Description Sections of the uterus reveal gravid uterine changes exemplified by decidualization of the endometrium and hypertrophy of the myometrium. Sections of the lower uterine segment as well as the three detached tissue fragments reveal presence of chronic villi, some with myxoid degeneration, on and within the upper layer of the myometrium without an apparent decidual plane. Diagnosis: Uterus, TAh = post-gravid uterine changes =c/w placenta accreta

Thu 07, May 2009 11:01am

thank you for explaining clearly the reasons about not removing the other overy and I understand. Yes they did a transvaginal ultrasound that very day of my operation. it was stated in the report that rule out accreta. The one that did the ultrasound is also one of the doctors that made the surgical procedure. I really would like to know your personal opinion espaecially with the large lobular structure and smaller nodule seen in my cervix, can it may be a sign of becoming cancer? it would really be helpful to me because i could plan for the next step like how to get it cured, but i will still do all the checkups and evaulation you have advice. but I really like to know.. I think today after reading your fierst answer not less than 25 times i keep on coming back to check if you have replied. again thank you from me and my family, may god be the one to repay you w/ blessings. ill be waiting for your opinion. thankx

Cervical Cancer? Need Diagnosis

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