Serous inclusion cyst of the ovary

Case contributed by Dr Ammar Haouimi

Presentation

Left pelvic pain.

Patient Data

Age: 65 years
Gender: Female

Large well-defined ovoid unilocular cyst (8 cm) arising from the right ovary and prolapsed in the Douglas pouch with minimal surrounding effusion. It displays a homogeneous low signal on T1 and high signal on T2 with no restricted diffusion or evident enhancement on postcontrast sequences. No internal septation or solid component.

Case Discussion

MRI features of unilocular ovarian cyst with no restricted diffusion, internal septation or solid component in a postmenopausal woman, suggestive of a serous inclusion cyst.

Recommendation for ovarian cyst in postmenopausal women

  • ≤1 cm: no need to report
    • impression: normal ovaries/adnexa
    • recommendation: no follow-up
  • >1 to ≤3 cm: report presence of simple cyst(s) and largest cyst diameter
    • impression: benign inconsequential finding
    • recommendation: no follow-up
  • >3 cm: report with all cyst diameters
    • impression: benign simple cyst
    • recommendation:
      • >3 to ≤5 cm: follow-up either in 3-6 months for resolution/re-characterization or in 6-12 months for growth rate assessment.
      • >5 cm: follow-up either in 3-6 months for resolution/re-characterization or in 6-12 months for growth rate assessment

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