Presentation
Pelvic discomfort.
Patient Data
Large well-defined ovoid unilocular cyst (7.5 cm) of supravesical location arising most likely from the left ovary, eliciting a homogeneous low signal on T1 and high signal on T2 with no internal septation or solid component. No restricted diffusion or enhancement on postcontrast sequences.
Focal thickening of the endometrium-myometrium junctional zone (thickness =18 mm) at the anterior uterine wall in keeping with focal adenomyosis (incidental finding).
Case Discussion
The MRI features of unilocular ovarian cyst with no internal separation, solid component or restricted diffusion in a postmenopausal woman is highly suggestive of a serous inclusion cyst. In such case, follow-up either in 3-6 months for resolution/re-characterization or in 6-12 months for growth rate assessment.
For more details regarding the recommendation of ovarian cysts in postmenopausal women, please refer to the article: ovarian cysts.