11/07/05 1. Normal abdominal US.
11/07/05 1. Large right ovarian cyst and a fluid debris level. Normal color Doppler flow is seen at the periphery of the right ovary.
2. Small follicle of no clinical significance within a normal size left ovary. Right ovary is significantly enlarged.
3. Tiny amount of free fluid within the pelvic cul-de-sac.
4. Significant thickening of the endometrial echo.
5. The most likely considerations in the differential diagnosis include a hemorrhagic cyst which can occur secondary to the hormone stimulation which occurs at the time of ovulation. This can also be associated with thickening of the endometrial echo if menstruation has not yet occurred. The patient's menstrual cycle is irregular and occurs approximately every 20 days. The patient is late for her period. According to mother and patient, there is no chance of pregnancy.
6. An endometrioma with a chocolate cyst has the same appearance as a corpus luteum cyst and is also associated with thickening of the endometrium secondary to endometritis and can also have free fluid within the pelvic cul-de-sac.
7. Less likely considerations include a teratoma or dermoid cyst, however, no obvious calcification is seen. Tube ovarian abscess can also have this appearance.