Presentation
45 years old lady referred by GP with abdominal discomfort. No significant prior medical or surgical history.
Patient Data
Central large mass lesion within lower abdomen and pelvis displacing loops of bowels laterally. Psoas muscles are in normal position. No calcification is seen within the mass. Findings are subtle at first glance. See annotated image.
No evidence of obstruction or perforation.
Mild lumbar scoliosis convex to the left.
T2 hyperintense and T1 hypointense, large (23 x 10 cm) well defined cystic mass arising from the pelvis (most likely from left ovary). There are no thick internal septations, papillary projections, solid component, nor evidence of peritoneal dissemination of disease.
Based on the lesion size and the morphologic features, ovarian cystadenoma was the favored diagnosis, with potential differential of a simple cyst or a borderline serous neoplasm.
Case Discussion
This case highlights the importance of plain radiography in identifying non-osseous findings.
Meticulous analysis of PFA indicated an abnormality which is quite vague at a first glance.
The patient underwent lesion surgical resection (which has confirmed that it was arising from left ovary) and histopathological analysis confirmed serous ovarian cystadenoma.
Ovarian cystadenoma is a benign epithelial tumor, however, may mimic more sinister entity such as cystadenocarcinoma.