If the ultrasound was normal, what else could this mass be?

July 6, 2011 5:19 PM

I know you aren't my doctor, but I'm just frustrated and hoping for some ideas while I wait for a follow-up appointment. For the last two months, I've developed a tender mass on the left side of my abdomen, right underneath the ribs. I noticed it during my last period, it stopped hurting after a few days, and now it's come back again with my next period.

I saw a nurse practitioner for it yesterday, and he verified that he could feel the mass, that it was about the size of a quarter, but said he didn't know what it could be. He sent me for an abdominal ultrasound this morning and I just got the results back; it was completely normal.

This is especially frustrating for me because over the last year and a half, I've been developing some sort of chronic neurological illness that nobody can diagnosis, and I'm so tired of doctors with confused looks on their faces saying, "Huh, well that does seem like a problem, but all your tests are normal."

I do, thankfully, have an appointment scheduled with the Mayo Clinic in Rochester next month, and I have a lot of hope that they'll be able to do something more for me.

But until then, does "tender upper left quadrant abdominal mass that comes and goes with menstruation" sound at all familiar to anyone? And does anyone have any advice on how I should follow up on this test result with my doctor? Is it even worth pursuing at this point or should I just ignore it?

posted by sunnichka to Health & Fitness (12 answers total)

My (inguinal) hernia was both more tender and more palpable when I had my period because so many other things were naturally more swollen around it. I think hernias show up on x-rays, but there's always a chance yours just didn't.
posted by cocoagirl at 6:00 PM on July 6, 2011

Perhaps it's an accessory breast.
posted by spork at 6:10 PM on July 6, 2011 [1 favorite]

Could it be a cyst? (although you'd think that would pretty easy to diagnose)
posted by Kololo at 6:31 PM on July 6, 2011

How about cysts with endometriosis? It sounds similar to what I experienced with a combination of those two. I thought I had appendicitis and my GP sent me to the ER where they just decided I had a burst cyst and severe endo. Memail me if you want. I'm guessing there's a lot more to the "undiagnosed illness" and I've SO been there...

My first sentence sounds like the worst proposition ever.
posted by guster4lovers at 6:59 PM on July 6, 2011 [4 favorites]

I'm def. not a doctor, but FYI the NYTimes just ran an article about how hard it can be to diagnose hernias in women.
posted by BlahLaLa at 7:04 PM on July 6, 2011

Have had an ultrasound, an MRI, & quite a few pokes & prods for a mystery nuisance on my left side & just under my ribs. Sometimes it can be felt & sometimes not. Something showed up on the MRI, but they couldn't decide what it was so went with "impaction" and put me on Miralax tablets. The other doctor who's hazaarded a guess has suggested that it is an unusual presentation of acid reflux with a touch of irritable bowel syndrom (wtf???). I must admit, although I don't remember excessive heartburn prior to the diagnosis, a month of Zantac & Citrucel tablets has alleviated the symptoms. Although I'm really not convinced they've really gotten to the bottom of it. None of this may apply to you, but since you're casting around for new ideas, that's a similar symtom in a similar location.
Also, and this may sound really stupid, but I haven't replaced my bras in a million years & they've gotten too tight. If I wear them every day I get a lot of discomfort along my bottom left rib. But I say that's because there's a problem on THAT side that they haven't figured out yet.
posted by Ys at 7:16 PM on July 6, 2011

I suffered from endometriosis for a good ten years before they could "see" it. The quack doctor who did the first surgery took my uterus but missed the masses. I finally got a good doctor who found the masses and got them out of me.

Find a good doctor. Get them to listen to you. If it is endometriosis (and I'm not saying it is, just if) then it will only get worse.
posted by patheral at 7:24 PM on July 6, 2011 [1 favorite]

Sounds to me like a hernia, endo, fibroid, or adhesions---or all of the above. Lap may be necessary to see it fully.
posted by stormpooper at 10:31 AM on July 7, 2011

Endometrial mass in the liver? Endometrial cyst of the liver?

Important, I think, to time the pain and the experience in detail and write it down. Keep an exact log of symptoms, places, sensations.

Neurological Complications of Endometriosis

Endometriosis Journey has one entry about neurological symptoms and treatment.
posted by nickyskye at 4:21 AM on July 8, 2011

Response by poster: Thanks for all the answers. It would be hilarious if I had an accessory breast. The endometriosis/fibroids/adhesions stuff sounds scary. The hernia suggestion surprised me at first, but now that I'm thinking about it, I have been experiencing some fairly violent convulsions (my neurologists aren't sure why I have these or what they are) that are especially hard on my abdominal muscles. I wouldn't be surprised if I've injured myself somehow. I'll let you all know if my doctors come to any conclusions. Thanks so much for your time.
posted by sunnichka at 2:13 PM on July 11, 2011

Response by poster: Oh, and Nickyskye, thank you for the articles about neurological symptoms of endometriosis. I was very intrigued, but unfortunately I don't have the kind of neurological symptoms described in the pubmed article. The Endometriosis Journey article, on the other hand--I'm confused as to how the endometriosis caused her migraine-type symptoms. It seemed that stopping her estrogen birth control relieved those problems.
posted by sunnichka at 2:19 PM on July 11, 2011

Response by poster: Not an accessory breast, but an accessory spleen . . . ?

Well, my doctors haven't come to any conclusions and have decided to leave the problem on the back burner for now, which is fine. BUT, as I am gathering up all my medical records together for an upcoming clinic visit, I'm seeing a note from radiology on a previous CT scan of my abdomen saying that I have an upper-left-quadrant abdominal nodule that they think is "accessory splenic tissue." So who knows, maybe that explains it.
posted by sunnichka at 3:08 PM on August 1, 2011