Presentation
Sudden severe pelvic pain
Patient Data
The ultrasound images demonstrate a large unilocular right ovarian cyst with two echogenic masses (39x28 mm and 27x10 mm) adherent to the cystic wall with convex shape towards the cystic lumen. No blood flow is seen on color Doppler (not shown).
Mild effusion is seen in the Douglas pouch.
Few MR sequences (T1WI/T2WI) were performed after the ultrasound examination confirming the previously described cyst within an enlarged right ovary with a peripheral displacement of the follicles. The masses adherent to the cystic wall and show a convex shape towards the cystic lumen mimicking masses arising from the cystic wall and are of high signal on T1WI, and low signal on T2WI (blood clots adherent to the cystic wall). Mild peritoneal effusion is noted in the pelvic region.
The uterus and left ovary show a normal appearance.
Case Discussion
Ultrasound and MRI features of a hemorrhagic ovarian cyst with blood clots adherent to the cystic wall mimicking mural masses.
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