Friday, January 18, 2008
Rectus Abdominis Endometriomas -- BENIGN
All three masses (yes....two more grew since my MRI on 12/26) were BENIGN!! My surgeon had to take a lot more muscle out than he has anticipated due to the extra masses. The pathology came back today and all three were rectus abdominis endometriomas which mean they were a tumor growth of endometrial (uterine) tissue specifically confined to my abdominal muscle. There are different therories on why an endometrioma occurs including seeding from a prior abdominal operation or translocation of endometrial cells through the lymph system. Since I have had an emergency c-section under general for Eli's birth, a laparoscopy, and a complete abdominal hysterectomy, I definitely have the surgical history to invite endometrial tissue to spread. Unfortunately, according to a study in the British Journal of Radiology on rectus abdominis endometriomas since they were first described surgically in 1993, "Rectus abdominis endometrioma, wherein the endometrial focus is solely confined to within the body of the rectus abdominis muscle is rare and sparsely reported in literature with only 11 new cases since it was first described". I am sure there are more cases presenting in the literature than 11 with endometriomas confined specifically to the rectus abdominis muscle but research shows they are "highly unusual" and "very rare" occurrences. Leave it to me to develop a rare medical complication. Time to play the lotto :)
All joking aside, I am overjoyed that my masses were not malignant. Cancer is a scary word and disease. I have been in a state of haze in the past month worrying about all of the what-ifs of my future. Soft tissue sarcomas of the abdominal wall do not have great morbidity and mortality rates and having that possible diagnosis looming in the back of my mind (or in the front on some days!) was crazy at times. The pathology of my masses showed large levels of fibrotic tissue surrounding each mass. I haven't been able to talk to my surgeon specifically about the patho report but the fibrosis should not mean there was any desmoid tumor development at all. I can't wait to go to my post-op appointment on Wednesday and get a copy of my patho report and be able to ask questions and see what my long-term prognosis is. My surgeon did warn Al that I have a "extremely high risk" of herniation due to the large amount of muscle he needed to remove. I know prayers from so many people helped me get through this with a positive outcome and I will pray that I don't herniate and have to go under the knife yet again.
As far as recovery goes....things have been interesting. The whole left side of my abdomen is TIGHT. I am sore and can't move much at all. I have almost no core muscle strength for lifting my left left or trying to sit up/down. I can feel the muscle defect to the inside of my left hip and even through the swelling I can see that both sides most likely won't match up once I'm healed. It's a small price to pay though. My incision is about 3+ inches long vertically and about an inch to the left and down from my belly button. Al is taking wonderful care of me and I am living on the couch downstairs during the day and in bed upstairs at night. One trip of stairs each way per day. No more...I can't take it. So far I do have to say that it has been different kind of pain then my hysterectomy with less aching and more direct pain. Everything is connected to using your darn ab muscles!! The boys are loving on me and coloring me pictures to make me feel better (which of course does!). Thank God for Al's laptop or I would feel completely disconnected. I miss all of the babies at work and the amazing people I have the privilege of working with. Hopefully recovery will go smoothly and I will be back to health and work in no time.
Thanks again for all of the prayers and well-wishes. They worked! I'm home and healing and my masses were BENIGN!! Oh what a day!