Presentation
Incidental finding on ultrasound of an incisional hernia.
Patient Data
The right ovary contains a multilocular thin-walled regular anechoic cyst measuring 58 x 41 x 36 mm which contains a larger cystic component measuring 48 x 36 mm x 41mm, and 2 smaller cystic components measuring 14 x 9 mm and 9 x 7 mm. There are no solid components, papillary projections, or abnormal vascularity. There appears to be some ovarian parenchyma seen peripherally. The ovary is mobile and non tender.
The left ovary was not seen, and no masses were evident in the left adnexa.
Normal postmenopausal appearance of the uterus which is of small volume (17cc) with thin endometrium (<2mm).
No pelvic free fluid.
Case Discussion
Multilocular cystic lesion with no features concerning for malignancy.
With reference to IOTA simple rules, it has one "B" feature (B4 - smooth multilocular <10cm) and no "M" features.
ADNEX score calculates 96% chance benign.
O-RADS Category 3 - Low risk of malignancy (1-10%).
Histology not available as the lesion was not excised. Stable size and morphology at 6 month followup.
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