OpenHealth Q&A

Get answered by medical professionals

Abnormal Uterine Growth

7/21/2025, 7:10:27 PMMale25-34

A 24-year-old woman has presented with a range of systemic symptoms persisting for around half a year, characterized by significant night sweats, persistent fatigue, mild fevers, noticeably swollen lymph nodes in several areas, small nodules in the lungs, and gastrointestinal problems. The patient is not currently on any medications and lacks a notable medical background. Laboratory tests reveal normal results, except for a Neutrophil-to-Lymphocyte Ratio (NLR) of 3.4. After experiencing new abdominal cramps, the patient underwent a contrasted abdominal CT scan. The scan identified a 2.7 cm irregular mass with peripheral enhancement located in the posterior myometrium, with the endometrium also showing enhancement. Importantly, the patient has no documented fibroids, and this mass was absent during a CT scan performed just six weeks prior. What is your assessment of this situation, and what further diagnostic steps do you propose?

ArthritisFibromyalgiaThyroid Disorders

Answers (1)

Cony

7/21/2025, 7:10:45 PM

OpenHealth AI

The situation you're describing involves a young woman with a significant and concerning abdominal mass, as well as a range of systemic symptoms. Given the recent development of the irregular mass and associated symptoms, it’s important to pursue further diagnostic steps carefully and systematically.

Main Points:

  1. Urgent evaluation of the irregular mass is necessary.
  2. Detailed diagnostic imaging and tests should be conducted to understand the nature of the mass.

Explanation:

The combination of systemic symptoms (night sweats, fatigue, fever, swollen lymph nodes, lung nodules, and gastrointestinal issues) alongside the discovery of a 2.7 cm irregular mass in the uterus raises concern for a potential malignancy or other significant pathology such as an aggressive benign tumor. The fact that this mass was not noted on the previous CT indicates rapid growth, which is unusual and warrants further investigation.

Next Steps:

  1. Referral to a Specialist: Given the complexity of the symptoms and findings, it is crucial to consult a gynecologist or a gynecologic oncologist who can assess the mass in detail.

  2. Biopsy of the Mass: A biopsy is the most definitive way to assess what the mass is. This could be done via hysteroscopy or through imaging-guided methods depending on the mass's location and characteristics.

  3. Further Imaging Studies: Consider obtaining an MRI of the pelvis to get a better sense of the characteristics of the mass and its relationship with surrounding tissues. If there are any concerning lung nodules, a CT scan of the chest may also be warranted.

  4. Comprehensive Blood Tests: Although initial laboratory tests were normal, consider repeating them to check for tumor markers or any signs of infection/inflammation (e.g., CBC, ESR, CRP) to guide management.

  5. Monitoring Symptoms: Keep a careful record of any new or worsening symptoms such as abdominal pain or changes in bowel habits to share with your healthcare provider.

  6. Consideration of Other Conditions: In the background of systemic symptoms, evaluate for other conditions that could explain the lymphadenopathy and lung nodules, including infections or autoimmune processes.

Conclusion:

It's critical to act promptly given the potential seriousness of the findings. Connecting with specialists for guided diagnosis and management, including biopsy and further imaging, will provide clarity on the nature of the uterine mass and guide the next steps. Please feel free to reach out if there are further questions or concerns during this process.

Related Questions

Bilateral CCA and ICA Stenosis with Vertebral Artery Issues in a 25-Year-Old Female

About two months prior, I experienced a fainting spell that led to a fall, resulting in a head injury that required two staples. In the weeks following this incident, I encountered various concussion-like symptoms. To explore the underlying cause of my fainting, I consulted both a cardiologist and a neurologist. The cardiologist conducted an echocardiogram and an EKG, which did not reveal any abnormalities. He suggested that my episode might have been a case of vasovagal syncope. However, my concern persisted as I had experienced fainting spells intermittently over the past six years, always sparked by identifiable triggers such as prolonged standing, heat exposure, or inadequate food intake. In contrast, during this latest incident, I could not pinpoint any specific trigger. I recently received the results from my neurological evaluations: **MRI and Autonomic Function Tests:** All were within normal limits. **Carotid Doppler Assessment:** - There was a moderate to severe delay detected in both the common carotid arteries (CCA), internal carotid arteries (ICA), and external carotid arteries (ECA). - The left vertebral artery showed a mild to moderate delay compared to the right side. - Increases in blood flow velocity suggest the possibility of stenosis in the bilateral CCAs, ICAs, and the left vertebral artery. **Transcranial Doppler Study:** - This examination was technically limited, revealing a mild increase in the left vertebral artery relative to the right, further indicating the potential for stenosis. **EEG (30-minute awake and drowsy recording):** - Results were abnormal with localized sharp waves or spike activity observed in the left frontal area of the brain. I am scheduled for an MRA, a comprehensive EEG, and a VNG/BAER test within the next month, but I find myself anxious about what steps to take while awaiting these appointments. I've seen online discussions linking stenosis to atherosclerosis, which troubles me given my age of 25, alongside a lack of significant personal medical history or hereditary factors that I am aware of. The only pertinent background information I can recall is my history of e-cigarette usage spanning approximately seven years. I successfully ceased vaping two months ago, following the fainting incident, yet I cannot help but speculate whether this could be a contributing factor to my arterial issues. Any insights or recommendations would be immensely valued! While I am committed to following my healthcare provider's guidance, I would appreciate any thoughts as I bide my time until my next consultation.

LupusThyroid DisordersInternal Medicine
Male25-34
12 minutes ago

Do Symptoms of Viral Meningitis Fluctuate?

Female in her 40s Approximately nine days ago, I awoke feeling unwell, experiencing a sore throat, a notably stiff neck, and a headache. Initially, I thought I had just slept awkwardly on my neck. As the day progressed, I started to feel better and enjoyed a pleasant weekend. However, come Monday, I was struck with intense pain that radiated from my neck to the back of my head. While I did not have a fever, the discomfort spread to my shoulders and presented a burning sensation. Although the pain was quite severe, it would subside slightly over time. After about six days, I began to notice a gradual improvement. Just yesterday, I felt fantastic—no neck pain, no headache, and my energy returned. Today, however, I have taken a step back; my neck is aching again (although not nearly as intensely as before), and my stomach feels off. Is this typical behavior for viral meningitis? I no longer have a sore throat and there is still no fever.

ArthritisFibromyalgiaInternal Medicine
Male25-34
42 minutes ago

Exploring Orthopedic Alternatives for TFCC Injury

A 43-year-old male, standing at 5’10”, has been diagnosed with a TFCC tear affecting his left wrist, which is not prioritized for treatment. After undergoing an ulnar shortening osteotomy, healing has progressed favorably, yet wrist complications persist. "Seven months following arthroscopic debridement and ulnar shortening surgery performed on his left wrist, the patient experienced some challenges due to a delayed union. Recent x-rays confirmed that the ulnar osteotomy has healed robustly. Although he reports a gradual improvement, significant pain continues predominantly on the ulnar side during lifting and specific movements. The patient has been able to resume full work duties but encounters some limitations with particular tasks. In the workplace, he utilizes a Velcro wrist brace, while outside of work, he opts for a wrist widget. He describes persistent popping sounds from the ulnar part of his wrist, which can happen unexpectedly during varied activities and at times results in discomfort. He has engaged in occupational therapy for approximately three weeks, focusing on building strength. Occasionally, he applies patches for pain relief but does not rely on other medications. **Physical Assessment** During the physical examination, the patient displayed excellent mobility in both the wrist and elbow. He showed no tenderness along the radial side of the wrist but reported discomfort in the ulnar fovea and some tenderness over the volar TFCC upon deep palpation. Compression testing of the TFCC elicited increased pain and crepitus. Testing for the distal radioulnar joint (DRUJ) and lunate-tremor (LT) showed no pain, crepitus, or instability. There remains some tenderness in the ulnar forearm area where surgical hardware is present. Grip strength appears strong while wrist strength is also satisfactory. The neurovascular examination returned normal results. From my records, I want to share detailed insights. I've hit a plateau in rehabilitation concerning my ability to lift a 35-pound box. Although I believe I can handle more weight, the shape of the box, which features grips that cause flexion of my wrist rather than promoting a stable, straight forearm position, causes pain and inflammation during lifts exceeding 5 to 10 pounds. Is there another surgical option available? I have access to a brace, but it resembles a customized soft cast splint rather than a comprehensive brace, wrapping around the inner side of my wrist from the thumbhole to halfway up the forearm. While it provides some assistance, it tends to pinch against my arm at its endpoint, and allows minor wrist flexion away from the thumbhole toward the pinky side. Can I find a more effective full arm brace that restricts motion while I work? Would using such a brace be beneficial, or risk complicating my mobility over prolonged hours? I’m weighing my alternatives carefully as I have a Functional Capacity Evaluation approaching, and being assigned long-term work restrictions could jeopardize my career, particularly in warehousing and mechanics, which I'm keen to avoid. In summary, I am dealing with a TFCC tear, experiencing negligible progress post-debridement and ulnar shortening surgery. Is there a way to effectively stabilize my wrist to enable me to lift weights up to 50 pounds?

ArthritisFibromyalgiaInternal Medicine
Male25-34
1 hour ago

Searching for Solutions to an Unexplained Hand Condition

I am reaching out to gather insights regarding a perplexing hand issue my wife has been battling. She is a 40-year-old, 5'6", 170-pound woman, a non-smoker without prior hand injuries until a year ago. Aside from using medicinal THC, she is not on any medication. Despite consulting various specialists, doctors seem to be stumped about her condition, prompting my desire to seek input from others. Here’s a detailed account: **Presenting Symptoms:** A surgical wound that refuses to heal, persistent redness and swelling, intermittent infections, along with the formation of scar tissue. **Consultations Undertaken:** We’ve seen three hand surgeons from a reputable establishment, along with the Infectious Disease unit and Rheumatology. Dermatology was consulted at the request of one of the surgeons but ultimately rejected the case. **Timeline:** - **Spring 2024:** My wife's index finger inexplicably became swollen and painful, with no prior injury or evident cause. Within days, her entire hand exhibited swelling. A cortisone injection yielded minimal results, leading to a suggestion for extensive exploratory surgery. A brace was prescribed to manage swelling but failed to restore functionality to her hand. Blood tests aimed at detecting systemic conditions like lupus and gout were conducted. - **August 2024:** Various hand surgeons assessed her imaging studies (X-rays and musculoskeletal ultrasound), identifying potential tendon complications. They recommended a surgical procedure aimed at alleviating tendon constriction, diagnosing it as non-trigger finger, and executed a standard A1 trigger finger release. - **September 2024:** Following surgery, an infection arose and was treated with oral antibiotics. - **Fall 2024:** Despite rigorous physical therapy, her finger's mobility was severely limited due to scar tissue accumulation. A subsequent cortisone injection had negligible effects, and her pain intensified. - **February 2025:** Two surgeries were conducted to enhance mobility: Tenolysis of the FDS and FDP tendons and removal of the ulnar slip of FDS. Prophylactic antibiotics were given owing to the previous infection. - **February 2025:** The surgical site did not heal properly, with an opening at the base of the finger exposing the tendon. - **March 2025:** Symptoms of infection arose, including severe swelling and discharge, leading to an emergency washout operation due to concerns over a septic joint and possible amputation, which was fortunately successful. Both intravenous and oral antibiotics were prescribed to combat staphylococcus aureus and staphylococcus epidermidis infections. - **April 2025:** Antibiotic therapy continued. Surgical wounds remained partially open with visible tendons and a recommendation for wound revision followed consultation with the surgical team, leading to further revision surgery and antibiotic prophylaxis. - **May 2025:** After further evaluations, my wife tested positive for HLA-B-27, indicating spondyloarthritis with peripheral dactylitis, which could have been the root cause of her swelling. However, the extent of hand swelling is inconsistent with this diagnosis, and rheumatology has expressed skepticism regarding this condition impeding healing or causing infections. Osteoimaging revealed a punctate foreign body that was not identified during initial evaluations. - **June 2025:** After another interval, a persistent tiny hole at the base of her finger remained, necessitating yet another wound revision. - **July 2025:** The site still showed no improvement, leading the surgical team to advise waiting for an additional 4 to 8 weeks. Unfortunately, infection resurfaced, presenting with pus, swelling, and heat, culminating in an emergency washout surgery and a 5-day course of intravenous antibiotics along with additional oral medication. The previously noted punctate foreign body was removed for further analysis. **Important Considerations:** The infection did not fit typical bacterial presentations, as the initial fluid didn’t show high white blood cell counts. The Infectious Disease department has continued to monitor her case without confirming an active infection, suggesting instead that the pus-like discharge might be serous fluid mingled with fibrous material. Currently, the fundamental cause of her symptoms remains unclear, but dactylitis is a potential explanation. We have been advised to seek emergency care if her finger swells again. **Key Symptoms Include:** - Significant swelling - Recurrent infections - Severe pain - Persistent non-healing surgical wound Thank you for any suggestions you may have. I’ll do my best to respond; some of this was relayed via voice-to-text due to her challenges with typing, so apologies for any typing mistakes.

ArthritisLupusCOPD
Male25-34
1 hour ago

MRI Findings and Interpretation

Greetings everyone, I’m a 43-year-old male, weighing 193 pounds, who has recently undergone surgery due to thyroid cancer, which involved a left neck dissection that lasted six hours. Post-surgery, I experienced debilitating neck pain along with headaches and tinnitus. After this, I consulted a neurologist who recommended that I undergo MRIs of my brain and neck. It took about a month before the procedure could take place. I have now completed the MRI, and while my tinnitus has subsided, I still have some moderate discomfort in my neck. Upon reviewing the MRI results, I found myself anxious regarding the findings related to my brain. I was informed that there are a few scattered areas of T2/FLAIR hyperintensities located in the bilateral subcortical white matter and corona radiata. These findings are considered nonspecific and likely indicative of chronic small vessel ischemic changes. My follow-up appointment with the doctor is still quite a ways off, so I was hoping someone could shed light on what this means. Thank you for your help! **TECHNIQUE:** The MRI utilized axial T1, FSE T2-weighted, FLAIR, MPGR, and diffusion-weighted imaging, alongside axial and coronal fat-suppressed T1-weighted images post gadolinium administration. A total of 19 ml of gadoterate meglumine (Dotarem) was injected without any adverse reactions. The examination was conducted on a closed ultra-high-field 3.0 Tesla scanner. **COMPARISON:** A CT scan of the head without contrast dated 3/20/2025 was available for reference. **FINDINGS:** There were no signs of restricted diffusion that would indicate an acute infarct. The scattered T2/FLAIR hyperintensities in the bilateral subcortical white matter and corona radiata are nonspecific and likely correspond to chronic small vessel ischemic changes. There were no signs of acute cortical edema, bleeding, abnormal enhancement, hydrocephalus, or midline shift. Additionally, a partially empty sella was noted, and both the paranasal sinuses and mastoid air cells appeared clear, with the bone marrow signal intensity of the clivus and calvarium remaining normal. No obvious enhancement was observed following gadolinium administration. **IMPRESSION:** There are no acute intracranial abnormalities detected. The few scattered T2/FLAIR hyperintensities in the bilateral subcortical white matter and corona radiata are likely chronic small vessel ischemic changes. A high-resolution CT of the temporal bone or an MRI IAC protocol with or without contrast is recommended for further evaluation should there be clinical concern for labyrinthine fistula. **For the cervical region:** **EXAM DESCRIPTION:** MRI of the Cervical Spine **TECHNIQUE:** Sagittal T1, T2-weighted, and STIR sequences were performed, as well as axial T1-weighted and MPGR from C3 to T1 on a 3 Tesla scanner. **COMPARISON:** None available. **FINDINGS:** The alignment of the cervical spine is normal. Notably, there is mild degeneration at C5-C6. The canal is congenitally narrow, but the cervical cord exhibits normal signal characteristics. The atlantooccipital and atlantoaxial joints appear normal, with marrow signals also being within normal ranges. - **C2-C3:** Normal; imaged only in the sagittal plane. - **C3-C4:** Present is a small midline protrusion causing mild canal stenosis. - **C4-C5:** Another small midline protrusion resulting in mild canal stenosis. - **C5-C6:** A small to moderate midline protrusion causing mild to moderate canal stenosis. Uncovertebral hypertrophy leads to mild narrowing of the bilateral neural foramina. - **C6-C7:** A tiny midline protrusion is observed. - **C7-T1:** Appears normal. **IMPRESSION:** 1. Midline protrusions are exacerbating the congenitally narrow canal resulting in canal stenosis from C3-C4 through C5-C6 as described. 2. Mild degeneration of the C5-C6 disc and uncovertebral hypertrophy contributing to slight bilateral neural foraminal narrowing. 3. The cervical cord remains normal.

FibromyalgiaCrohn's DiseaseThyroid Disorders
Male25-34
1 hour ago