Ovarian follicular cyst

Case contributed by Dr Matt A. Morgan

Presentation

Patient presenting for further evaluation of uterine fibroids

Patient Data

Age: 30 years
Gender: Female
MRI

There is a 4.4 cm well-marginated uniformly T2 hyperintense and T1 hypointense cyst in the left ovary. It has a single thin nonenhancing septation. No mural nodule, wall irregularity, or thickened septation. The other follicles in the ovary are normal size and appearance.

On post-contrast imaging, there is a thin enhancing rim around the cyst wall.

There are also multiple uterine fibroids.

Case Discussion

This case shows an example of an ovarian follicular cyst (or "physiologic cyst"), a dominant follicle in arrested development that failed to rupture. This is a common normal finding in premenopausal women. A cyst <3 cm is generally termed a "dominant follicle," whereas those larger are considered "follicular cysts." These cysts generally resolve in 1-2 menstrual cycles. Cysts larger than 7 cm on ultrasound are frequently evaluated with MRI since ultrasound may start to become limited with larger cyst size. Rim-enhancement is a normal finding in follicular cysts and does not imply underlying malignancy.

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