MRI Findings (No Diagnosis Yet)

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cricket92
Posts: 1
Joined: Fri Nov 01, 2024 2:08 pm

MRI Findings (No Diagnosis Yet)

Postby cricket92 » Tue Nov 05, 2024 5:58 pm

Hello,

I am not sure I should be here yet as I do not have a diagnosis of CRC and may or may not be in the near future. I have just been having a hard time focusing on anything but CC since my MRI finding.

Long Backstory- I am a 32 year old mom of 2 young kids. 5 years ago when I was pregnant with my first, I could feel a small lump/mass in my left pelvis region. I went for a PCP appointment from which my bloodwork indicated I was pregnant (super early, my period wasn't even due yet). They sent me for pelvic ultrasound but didn't find anything, it was suggested I had anxiety, and I was told to focus on my pregnancy. So I did and put the mass out of my head. Fast forward past my second pregnancy (baby 2 born 14 months after baby 1), and I feel around my abdomen and again am bothered by this palpable mass which I feel has grown. I go to obgyn, she 100% feels it, sends me for pelvic ultrasound which finds nothing. She refers me for CT which insurance denies. I pay out of pocket for the pelvic CT. Nothing is found. Obgyn never returns call. I am agitated but return to my busy life with 2 under 2 and working full time.

Last year after years of increasingly heavy periods that affect my ability to work for several days each month, I faint twice in an elevator while on my period. I go to a new Obgyn who orders lab work and I'm severely anemic. My hemoglobin was 6.3. I do have a genetic form a mild anemia, however I consistently have always been between the 10/11 range, dipping into the 9's only during my pregnancies. The obgyn after hearing about how extremely heavy my periods are strongly believes that is the cause and gives me options to remedy. I do not mention my lump to her, because I want to see if she mentions them upon my examination. She immediately does, expresses concern, and sends me for yet another ultrasound that finds nothing aside from a few small fibroids which aren't located where the mass is felt. I find it baffling that multiple doctors, despite FEELING something, shrug it off when they don't SEE something on the imaging. I also mention dull lower back pain that feels like its internal, which gets no attention. We agree upon endometrial ablation to rectify my period issues and I go on a regimen of iron to get my levels back up. I have the endometrial ablation in October of last year which is, in fact, life changing for me. I again put aside my concern for my pelvis/abdomen and assume I just have health anxiety.

FF again to a few weeks ago when I feel around again after I notice the back pain isn't intermittent but fairly constant. It feels like the lump I feel is larger and expands up. I also keep seeing young people on various social medias telling stories of their various cancers that are discovered late because they either have no symptoms or have symptoms that are repeatedly ignored until they are finally diagnosed. I have a freak out imagining I possibly have cancer and by not advocating for myself better I may be leaving my children motherless in the next decade. So to stop my worrying, I book a self-pay full body MRI through SimonMed here in Arizona. Mostly I hope nothing is found and that I can get a grip and not worry about what is apparently nothing.

I go to the scan, feel pretty silly with myself as its being done, and wait for the report. A few days later, I get the report. Nothing abnormal in my pelvis, female organs look good aside from an anomaly with my uterus that thankfully didn't affect my pregnancies. Nothing out of ordinary on my left side where I feel the lump. HOWEVER. My cecum has a 3.6cm by 2.7cm mass. Which is the right side, not left, so I'm shocked. This mass is high signal on T1 and T2 weighted images. It's shape is similar to an egg, though more like the size of a walnut. The radiologist's report said it would be suggestive of a benign lipoma, except that on the fat saturated images the mass remains lit up, which if it's a lipoma it shouldn't. Because of this, the recommendation is for a GI follow up for colonoscopy. So I immediately schedule a PCP appointment so I can get a GI referral. The PCP appt is tomorrow so hopefully it won't be too long for the GI/colonoscopy.

A week later I had the scheduled call with a PA from SimonMed to go over the report findings, which I hoped would ease my mind. But no, the PA tells me this is urgent and not to delay being seen. I confirm with her that the concern arises from the mass remaining high signal on fat-sat imaging. I directly ask how concerned I should be, and she says I wouldn't lose sleep over it...pauses... then says "well I myself would lose sleep over this".... I'm like okay that's awesome. The only other issue is my spleen is enlarged, but that is not abnormal with my genetic anemia.

So, of course I'm pouring over the internet to try to figure out what this could be. I can't find anything, benign or malignant, that is high signal on T1 and T2 images but also high signal on fat-saturated images. It's so frustrating and I know that finding something wouldn't necessarily be what I have going on, but I like having a sense of understanding about things so it's tough knowing nothing now. It is crazy to think my anxiety over something unrelated could have saved my life if this turns out to be CRC. It is a decent size mass, which I'm happy to read on this forum isn't necessarily meaning it's worse than a smaller mass.

The exact description from the report says- "A 3.6 x 2.7 cm T1 and T2 hyperintense cecal mass is identified (25/5). No significant loss of signal is seen on the fat-saturated images. This was not visualized on the CT pelvis of 4/28/2022."

Does anyone have MRI knowledge that would maybe indicate it could still be a lipoma? I know it will be awhile yet before I have answers from a doctor, but I appreciate any knowledge found here.

Also, I don't necessarily have symptoms of CRC. I have always had bowel issues and stayed more on the constipated side of things. I sometimes have trace amounts of red blood in stools, but I definitely have a hemorrhoids from pregnancy that easily explain that. I believe bleeding from the cecum would be dark or tarry? I have also had tons of increased gas in recent years but I also can't really distinguish that from changes I went through from pregnancies. I have gained weight in the last year, too much actually, not lost which I know weight loss is another symptom.

Yeah. Sorry for the novel. I have read a ton on here and felt it was safe to get it off my chest here. Thank you.

roadrunner
Posts: 516
Joined: Sun Jan 12, 2020 8:46 pm

Re: MRI Findings (No Diagnosis Yet)

Postby roadrunner » Wed Nov 06, 2024 4:56 pm

First, you remind me of me, which I’m not sure is a good thing! ; )

You’re clearly very smart, analytical, and intense. That can serve you well in dealing with health stuff and health care, but sometimes even us research and analysis maniacs hit thick foliage we can’t cut through. I took a quick look at this, and I think that’s where you are here. You no doubt know the usual suspects, including simple lipoma, which you mention. The information you gave beyond the fact that it lights up on T1 and T2 images, but stays there on fat-saturated images, raises questions I couldn’t answer with the material I found. But you know that already. If there was any more reported detail, please post it and I’ll give it another shot research-wise. If not, I think you’re stuck with your upcoming colonoscopy and its findings. Bottom line is that I think additional detail (which the radiologist may not have given) is necessary to start analyzing the possibilities. FWIW—not much, unfortunately—in the quick look I took the “bad guys” were very uncommon to rare and did not appear to fit well.

Finally, one potentially useful suggestion. If you know any radiologists or have friends who do, it might be time to call
I’m a favor. If not, you’ve got the colonoscopy.

Sorry I couldn’t help much. Maybe someone else has more knowledge than I in this area and can do better. I totally understand your frustration and concern, but for now I’d just say that it’s worth getting the exam, but that it looks like most candidates here are benign.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20
Chest CT 3/30/21 growth 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy 7/7/23
5 cycles FOLFOX
APR 6/24. NED for now


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