Presentation
Abdominal pain and swelling.
Patient Data
A left adnexal cystic lesion shows mixed-signal intensity that indicates both fat and high proteinaceous material. No sign of hemorrhage or infection. Its wall measures < 3 mm with no internal septae. No soft tissue component or suspicious enhancing mural thickening.
The right ovary revealed no adnexal lesions with hemorrhagic corpus luteal cysts.
The retroverted uterine body is effaced by the adnexal lesion.
Mild pouch of Douglas collection.
Case Discussion
The T1 and T2 hyperintense components nilling on fat suppression sequence are consistent with fat content. The T1 iso- and T2 hyperintense signals that are persistent on fat suppression sequences represent high proteinaceous material.
A Rokitansky nodule is seen as a round structure protruding into the cyst lumen which is characteristic for mature cystic teratoma of the ovary. It can reach a large size, as in this case.
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