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Cystic ovarian neoplasm (benign)

Case contributed by Varun Babu
Diagnosis probable

Presentation

Abdominal fullness and early satiety. Ultrasound revealed a pelviabdominal cystic lesion.

Patient Data

Age: 30 years
Gender: Female

Left ovary is not separately visualized. A large pelviabdominal multiseptated cyst is replacing the left ovary, occupying much of the abdomen and displacing abdominal viscera. It is not infiltrating adjacent organs. It has a smooth, thin wall. The internal septae are fine and there are no mural nodules. The post contrast study reveals mild enhancement of the smooth walls. No internal cyst enhancement. Normal uterus and right ovary. No pelvic lymphadenopathy. No ascites. No other focal abnormality. 

Case Discussion

It is not uncommon to find young ladies presenting with cysts that occupy the entire pelvis and abdomen. A feeling of fullness of early satiety might be the only suggestion. Fortunately with ultrasound, an easy screening modality, these lesions are encountered quite frequently. Any ovarian cyst needs to first be categorized as benign or malignant.

Ovarian cysts larger than 5 cm go in for a resection, irrespective of the nature. The warning signs on imaging are solid internal components, irregular thick septa or internal vascularity. Cross-sectional imaging enables confirming the origin of the cyst. More often than not, the non visualization of one ovary is the main indication of the origin of the cyst. 

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