Hemorrhagic ovarian cyst

Case contributed by Dr. Abdullah Adawy

Presentation

Right pelvic pain with history of ovarian cysts. An intrauterine contraceptive device is present.

Patient Data

Age: 30 years
Gender: Female
Ultrasound

The right ovary shows a cystic lesion with anechoic contents as well as numerous echogenic septations forming a hyperechoic component. No internal vascularity could be detected by color Doppler interrogation and pulsed wave examination. The cyst measures about 6.0 x 6.7 x 7.6 cm.

The left ovary is of normal size, measuring about 2.0 x 3.2 cm, with a normal shape and echotexture. No abnormal cysts or masses could be seen. 

The uterus is normal size, measuring about 3.1 x 3.3 x 8.8 cm, and shows a normal echopattern and no focal lesion. IUCD is in a normal position.

The cervix has a normal appearance with no focal lesion.

Minimal anechoic free fluid in the pouch of Douglas, likely physiological.

No abnormal pelvic collection.

Case Discussion

The images are compatible with a hemorrhagic cyst in the right ovary.

Hemorrhagic ovarian cysts should be differentiated from ovarian neoplasms, which show solid nodules or papillae with vascularity on color Doppler. 

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