Pelvic pain right greater than left

Pelvic pain right greater than left. PV discharge. Postcoital bleeding.

Menorrhagia. History of endometriosis.

Findings

Transabdominal and transvaginal scans were performed with the consent of the

patient. No prior imaging is available for comparison.

The uterus is anteverted measuring 96 x 39 x 43 mm (83 cc). There is a

right fundal intramural fibroid measuring 14 x 14 x 12 mm. Endometrial

thickness is 5.8 mm. No endometrial lesions. Cervix is normal.

The right ovary is grossly enlarged measuring 106 x 60 x 86 mm (288 cc).

There is a multi loculated cystic lesion measuring 99 x 53 x 73 mm which

demonstrates internal echoes and thickened septations measuring 3.3 mm, and

there are two small mural nodules measuring 3.3 and 3.6 mm respectively,

with foci of internal vascularity in the thickened septation. The left ovary

is also difficult to separate from the right adnexal lesion, although

measures approximately 46 x 34 x 24 mm (16.5 cc). No free fluid.

Conclusion

Complex cystic lesion associated with the right ovary, containing a

thickened septation and two small mural nodules and foci of internal

vascularity, for which the differential includes a cystadenoma or possibly a

cystadenocarcinoma. An endometrioma is less likely given the foci of

internal vascularity. Gynecology referral recommended.

Thank you for referring Melissa Roberson.