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Conflicting OR and Pathology report

Hello! Recent hysterectomy due to pelvic pain, large fibroids, cysts, painful sex, heavy periods, anemia, etc.. inquiring opinions on if I should push further from OBGYN on possible diagnosis of endometriosis due to conflicting OR and pathology report. Could anybody share if similar situation? It doesn’t appear the pathology report includes any histology/microscopic study and doesn’t mention the lesions on outside of uterus. I also saw pictures of my uterus with multiple black lesions post op (my OBGYN took a picture and showed me). Following is from the OR report/OBGYN: “The patient had powder burn lesions on the anterior uterine serosa consistent with endometriosis. No other endometriotic implants were noted”. The pathology report does not mention these lesions on the outside but instead mentions the inside layer/myometrium. Pathology report: “The uterine serosa is tan and smooth without adhesions. The endocervical canal is tan and trabecular. The endometrium is soft red-tan averaging 0.2 cm thick. No endometrial mass lesion is identified. There are multiple submucosal myometrial nodules as well as trabecular adenomyosis. The myometrium is distorted by whorled rubbery well-circumscribed myometrial nodules up to 7 cm. No necrosis is identified.” I may be overthinking, but concerned on why those anterior uterine serosa lesions are not mentioned in the pathology report nor no microscopic study was completed. Any opinions would be greatly appreciated!

  1. First, let me say that I hope you are finding some relief from your surgery!

    That lab report definitely has a lot of technical terms in it. We're not medical doctors or pathologists here, so we can't explain what all that means. I'd definitely suggest you ask your doctor to go over everything in terms of endometriosis or anything else. I've had a lot of different experiences post surgery, and I definitely had to get some extra clarification after my first two procedures. I know I had pathology reports on my first surgery and my last, but not my second. I can't tell you why, but I'd go back and ask my doctor about it if I could!

    And I recently had 8 suspicious lesions removed, but only one was actually lab-confirmed endo. So it's hard to know what's going on based solely on a picture. But your medical records are your property. Don't hesitate to take your images and the report to another doctor to get a second opinion. Wishing you well and keep us updated! - Keri (Team Member)

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