Case 51
Clinical Presentation
A 42-year-old woman with increasing abdominal girth.
Imaging Findings
Transvaginal ultrasound images show a complex cystic mass (asterisk) in the right adnexa. The cyst has a thick wall (arrow). Although there are no septa, papillary projections are seen extending into the lumen from the wall of the mass (arrowheads).
Differential Diagnosis
• Malignant cystic ovarian neoplasm: A thick-walled cystic mass with papillary projections arising from the wall is characteristic.
• Benign ovarian neoplasm: Benign ovarian neoplasms can be large. However, thick walls and papillary projections go against this diagnosis.
• Endometrioma:
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