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Thursday, December 12, 2013
Course of action question
I have had FBD for a few years. During the last year and a half a couple of the cysts have grown to 1.5 cm and have become painful. I had one of them aspirated (ultrasound-guided aspiration) a week ago and the brownish colored fluid was biopsied. The pathologist said the sample had "pre-malignant papillary features" so my radiologist wants to repeat the US in 3 weeks to give time for the lump to refill with fluid. Using ultrasound she will then mark it for removal by a surgeon. Does this sound like the logical next step for treatment? How soon after that US will surgery take place in most cases? Any info is appreciated.
Yes - this sounds like a reasonable management plan. If the cyst needs to be removed but is no longer visible on ultrasound, then the fluid must reaccumulate before the mass can be seen in order to be resected. Usually the radiologic marker is placed on the same day as the planned surgery.
Jean T Stevenson, MD, FACS
Associate Professor of Surgery
School of Medicine
Case Western Reserve University