ovary, ovaries, genitourinary tract, genitourinary system, woman, Art in Anatomy, Ashley Davidoff MD, endometriosis, endometrioma, chocolate cyst, ultrasound, CT scan

Endometrioma of the Ovary on Ultrasound

A 25 year old female presents with painful menses. The ultrasound shows a cystic mass in the pelvis with a large amount of debris in the cystic cavity consistent with a chocolate cyst (a).  Image b is an overlay showing the fine granular appearance of the sediment.  When the patient is in decubitus position (c) , the sediment settles to the depending portions with a clear supernatant.  Image (d) is a CT scan of the same patient showing a non specific cyst in the left ovary. In this instance CT has little diagnostic value in the characterization of the abnormality other than localising a large cyst, and excluding other causes for the pain.  Although the appearance on the ultrasound is consistent with endometriosis, a hemorrhagic cysts is possible and the distinction may only be made pathologically.

Description

A 25 year old female presents with painful menses. The ultrasound shows a cystic mass in the pelvis with a large amount of debris in the cystic cavity consistent with a chocolate cyst (a).  Image b is an overlay showing the fine granular appearance of the sediment.  When the patient is in decubitus position (c) , the sediment settles to the depending portions with a clear supernatant.  Image (d) is a CT scan of the same patient showing a non specific cyst in the left ovary. In this instance CT has little diagnostic value in the characterization of the abnormality other than localising a large cyst, and excluding other causes for the pain.  Although the appearance on the ultrasound is consistent with endometriosis, a hemorrhagic cysts is possible and the distinction may only be made pathologically.