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Endometrioma

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Pelvic pain.

Patient Data

Age: 35 years

Pelvic ultrasound

ultrasound

The uterus has normal size and echotexture, with no evidence of focal lesions. The endometrium measures 8.3 mm in thickness.

The left ovary demonstrates a large cyst that has fluid-fluid level within and predominant homogeneous ground-glass echoes, measuring 64 x 56 x 60 mm (V. ~ 105 ml). The right ovary has a hemorrhagic cyst measuring 48 x 40 x 41 mm (V. ~ 41 ml). Both ovaries demonstrate vascularity on color Doppler. There is a small amount of free fluid, anechoic.

Both kidneys have normal sonographic appearances, no hydronephrosis.

Case Discussion

The sonographic appearances are those of a right ovary hemorrhagic cyst and a left ovary likely endometrioma, with no signs of torsion. 

A gynecological review has been recommended, as well as further imaging follow-up in a 6 weeks time. 

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