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!

17 comments:

Anonymous said...

praying for you to have a speedy recovery

Jessica (ivysmom) said...

Thank goodness!! I hope you have a smooth and easy recovery (((hugs)))

Jen said...

YAY! i am praying for a very smooth recovery! hang in there!!!

Jen
(landonsmom)

SunnyIvy said...

Great news Kellie!! Hope you heal quickly and are back to your old self again soon! :)

Misty

Amanda said...

I have tears in my eyes! I am so glad you are fine! Praying for a speedy recovery!

joybucket said...

Oh, I'm so happy. That's great news!

tiffany said...

Your news made my night! I am so thrilled for you (as are the rest of us on the board), Tiffany

abby said...

Great news, Kellie! I was thrilled to read that the masses were benign and I hope that the recovery goes okay---it doesn't sound like much fun but it's great to have such supportive boys around you.

baby james said...

So glad to hear the good news. Here's to a heathly and speedy recovery.Tracy

Jennifer said...

this is wonderful to read Kellie - I hope the rest of your recovery goes as smoothly :)

mylissa said...

You don't know me, but I am "googling" away tonight as I and my family try not to panic about my last week's news. Dr. found (through CT scan) a "nickel sized" mass buried in my rectus abdominis. They think it is from laporoscopy over 10 years ago. With my history (long) of endometriosis, I had a partial hysterectomy last year, when I insisted that the pain was higher. But, also, I trusted. Now, surgeon and OB are thinking that this could or could not be an endometrioma, hemotoma, or tumor. That's got everyone talking about removing the THING and urging me to consent to their cutting through the muscle to grab my remaining ovary and cervix. They're saying that a serious case of endometriosis, as I have, leaves no guarantee of a cancer and problem free future, but that getting all hormones out is better. I don't want to do that! But, I don't know what to do. I hated having the surgery I had already and am dreading even the removal of the THING, not to mention, as you said, the possible "C" word! I have 2 little girls, 3 and 5. My husband is very supportive. And, there is nobody to talk to who has ever even heard of having a mass in the rectus abdominis! Thank you for your blog. Best wishes to you and your recovery. Already, you have helped someone. I mean, it's promising that you are typing already. God's peace and Blessings to you and your precious family.

Dawn said...

Kellie
You don't know me either...I too just had a rectus abdominis endometrioma removed (12/5). We were highly suspicious that this was what it was when we went in (after finally finding a gyn that would listen to me). I had cyclical pain since my periods returned after the c/section of my first daughter 12 years ago. It was about 4 cm in size when it was removed. And yes...the pain is very different than after the c-section. How funny...I researched this for so long thinking that this is what I had but unable to convince anyone...and there aren't a lot of cases. Just fooling around on the internet tonite I've found several! Good luck with everything!

jenjyrel said...

You don't know me, but I found your site today and really would like to talk to you. I am going to the dr. today about possible endo in the left abdominus muscle. I had an MRI done in Dec. 2008 that showed 2 masses that they think are suspicious for endometriosis in the left abdominus rectus muscle. In October 2008 I had surgery to remove a bump just above my c-section scar, and it was confirmed to be endometriosis. I told the dr. to also get the spots that hurt up higher, closer to belly button area. But, of course he couldn't get to them during the surgery. I didn't have a sonogram or MRI before the Oct. 2008 surgery. I've had 3 c-sections and 3 amnios previous to all the problems w/ endo (no previous problems w/ endo, only after the c-sections). I am wondering if I should just live with the pain from the endo or would you recommend me having the surgery to have it removed? My concern about just living with it is that it might spread, which would mean possibly more surgery in the future. My pain is only with periods; my periods are messed up because of the endo (I'm assumming). I am curious to know how your healing was long term for you. Can you move about and walk and do normal activities or does it bother you where they did surgery? Does your belly look lop sided or anything? Is it hard to have a nice looking stomache after this type of surgery? Not that I have a nice looking stomache now or anything, but just wondering. Thanks for any info you provide. I don't mind if you contact me by my email or anyone else that reads this that wants to talk about this problem. jlw2875@hotmail.com I'm not used to doing the post stuff, so I'm not sure if I'll be back on here to read if someone posts in reply. But, I can try. I'm better about checking email. Thanks!
jenjyrel

Anonymous said...

Hi, it was great to find your site. I had a ct scan about 2 weeks ago that said I had a 2 cm soft tissue mass in the left Rectus abdominus muscle. I went today for the MRI - now just waiting for the results. I have had 2 laporoscopy (over 7 years ago) and an emergency C-Section (2yrs ago). I am nervous about the results but feel a little better after reading these posts. It gives me a better understanding. It does seem that everyone has had a c-section or lap.

God bless and thank you for your post.

Anonymous said...

Finally found some useful information! Thanks to all of you! I am 36 yrs old and had a classic C-section 16 years ago today (dry birth and baby needed to come out!)but no other tummy surgeries. Then...in 2007 I was diagnosed with a cycle related endometrioma right near my c-section scar(only shows up a few days before my cycle, hurts like crazy and is gone in a about 3 days). A week after my last cycle I felt a sharp pain in the middle of my lower tummy - like a cycle cramp - below navel and above my c-section scar area. I had a CT scan done and was told i have a 2-3 cm mass attached to my rectus abdominal muscle. Being referred for surgery. I am very sad, I just had my thyroid removed 1 year and 1 month ago and this surgery business is pure torture. Can anybody give me an idea of what to expect regarding pain and/or recovery time estimates. I was just starting to feel good after thyroid surgery and now this! Thanks for the support!

Anonymous said...

So glad that I found this today. I was a very scared woman after I perplexed the doctors with the mass they found after a CT scan and MRI 2 weeks ago. Surgery revealed that the mass was endometriosis in my left rectus abdominal muscle. From what I can tell, it's pretty rare. I have has 2 previous c/s, the most recent in 2009. Thanks for sharing your story as I am not alone....

Crystal said...

I just had surgery yesterday to remove a golf-ball sized endometrioma from my rectus sheath muscle & am feeling great!! I had a mesh put in but feel SO much better than I did before surgery! Thanks for your story - it's nice to know that I'm not the only one out there!