Wednesday, March 4, 2009

Cyst II

A forty year old woman presents with pelvic pain, dysmenorrhea, and dyspareunia. The ultrasound shows a characteristic adnexal mass:

Here is what is seen on surgery:

If the cyst were broken, you would find a thick brown tar-like fluid. This is not a hemorrhagic corpus luteum cyst.

Challenge: What kind of cyst is that?

Both images shown under fair use.

3 comments:

deardoc said...

'chocolate cyst' of endometriosis...i suppose

Alex said...

chocolate?

Craig Chen said...

Cyst II

Endometriomas present as a pelvic adnexal mass from growth of ectopic endometrial tissue within the ovary. They contain thick brown fluid (thus called “chocolate cysts”) and are often densely adherent to surrounding structures. On the ultrasound, the long arrow notes post-cystic enhancement and the short arrow notes homogenous ground-glass appearance characteristic of an endometrioma.

Sources: UpToDate, first image originally from Thomas Shipp; www.obgyn.net.