Ovarian mucinous cystadenoma

Case contributed by Maulik S Patel
Diagnosis almost certain


A female patient presented with complaints of two episodes of post-menopausal bleeding during the last six weeks. She had menopause for the last 13 years. There is a past history of two LSCS and a tubal ligation surgery.

Patient Data

Age: 60 years
Gender: Female

Transabdo & transvaginal scan


There is a large lesion in the lower abdomen and pelvis. It is a multilocular cystic lesion with low-level internal content. There is no solid nodule/ papillary structures/ wall irregularity/ wall vascularity. There is a presence of a few tiny calcification foci. The cyst size is 225 x 200 x 105 mm. The left ovary is not separately seen.

The uterus is anteverted with a normal postmenopausal appearance. The uterine cervix is normal. The endometrial thickness is 3 mm. There is no endometrial collection. 

The urinary bladder is empty and compressed by the lesion.

There is no ascites.

Case Discussion

The case shows a 23cm left ovarian multilocular cystic lesion with a few calcification foci in a postmenopausal female.

According to IOTA simple rules, this is an indeterminate lesion (No B or M features).
ADNEX score: 84% chance benign

According to the O-RADS risk stratification, this is an O-RADS 4 lesion (intermediate risk, 10-50% risk of malignancy)

Surgical excision was done and the histopathology proved the lesion being an ovarian mucinous cystadenoma.

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