I was originally diagnosed stage 3 in January 2019. After surgery I did a year of Opdivo. I have been NED. I recently had my routine pet scan. The doctor said there was no evidence of metastasis. But there was some activity in my ovaries again but most likely due to my PCOS (polycystic ovarian syndrome). So I was happy about the ‘boring’ scan. Well the scan report was just posted in MyChart.
This is the impression that was reported:
1. No definitive evidence of active residual malignancy.
2. Small bilateral ovarian cyst are again seen, larger on the left. There is now diffuse hypermetabolism throughout large bowel which is likely physiologic. Activity now overlies the left ovary level of cystic region measuring up to 2.4 cm and more likely represents misregistered activity from bowel. However, it is somewhat higher level and localized over the ovary and activity from the ovary cannot be entirely excluded. If this is from the ovary, it may represent activity associated with physiologic cysts. Malignancy would be felt unlikely. This can be evaluated on follow-up imaging.
3. Again, prominent palatine and lingular tonsillar tissues with a hypermetabolism could be reactive or inflammatory/infectious in etiology.
So my concern is what was seen around my ovaries and large intestine. This is what was also written in the narrative part of the report:
ABDOMEN / PELVIS SOFT TISSUES:
There is physiologic activity throughout the abdomen and pelvis within liver, spleen, GI and GU system.
No abnormal soft tissue metabolic activity is seen to suggest malignancy.
No enlarged or abnormal appearing lymph nodes.
No solid organ lesion is seen to definitively suggest malignancy. Again, small bilateral ovarian cyst, on the right measuring up to 1.6 cm and the left 2.0 cm. There is hypermetabolism overlying the left ovary, but may be misregistered activity from adjacent large bowel. However, it overlies specifically the ovary at the level of the cyst and a region measuring up to 2.4 cm and has SUV max 9.5. Activity otherwise within adjacent bowel has SUV max 6.8.
No hollow viscus lesion is seen to suggest malignancy. There is moderate to intense hypermetabolic activity seen throughout much of the large bowel on current exam.
No free air or fluid. No retroperitoneal air or fluid.
So now I am a little concerned and just wondering what others think. Is this something you would be more concerned about? Could it be melanoma? Another type of cancer? Nothing? My next scan is in 5 months. Should I request another scan sooner?