Wednesday, January 30, 2008

"Inside the lump he found teeth and a spinal column..."

"Yes, inside the lump was my twin." Aunt Voula from My Big Fat Greek Wedding.

So we've written previously about Krista's suspected dermoid cyst. Today was the big day that we were to have our second ultrasound and hopefully learn the sex of our baby (more on that later). While we were there, they wanted to inspect and carefully measure the cyst to see if it is changing. Change is bad as it is a sign of cancer. We suspect that this particular cyst has been around for at least a few years as Krista had some problems related to it a while back and they found it by CT scan. The doctors at the time told her it would most likely go away because most cysts do. Had they looked at it more closely they probably would have noticed that it wasn't simply an enlarged ovarian cyst. The ultrasound image below was taken today (we requested a copy so we could share the fun).

The cross hair looking measuring lines mark its location. You can look at the two figures below for more details. The first is my highlighter rendering of the doctor's drawing of the cyst following the exam. The second is the ultrasound image with the cyst outlined and some fun computer writing, because let's face it, it's darn fun drawing and writing with a mouse. So there is a thick wall that surrounds it and there does not seem to be much of a blood supply (a good thing I guess). Inside is a fluid filled cavity (dark on the scan). The fluid surrounds the solid part, except where it connects to the wall. The various blue parts are solid and appear to be mostly fatty tissue. Unfortunately our chances of getting anything cool like teeth and bones are much smaller than we hoped. But all is not lost! There is a very bright spot in the middle that casts a long dark shadow underneath it. This spot is most likely calcified (doctor code for tooth and bone like).
Two good things fall out from the presence of the cyst. First, we get extra ultrasounds. Today, for instance, we got three. And we will likely have them every 4-5 weeks until we deliver to monitor the cyst. Second, Krista may have a scheduled C-section to deliver the baby. If she does, doctors can then remove the cyst immediately after delivering the baby. You know, since they are there already. The downside? Well we have to be very watchful for any twisting of the cyst. These cysts are reported to twist during pregnancy as much as 20% of the time. The doctor said in his experience though that number is quite high. Our level of concern is watchful, nothing more at the moment. If it does twist, we will have to rush to hospital to have it removed immediately. Hopefully that won't be necessary.

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