Case Challenge

Genitourinary (GU)

Stephen J Pomeranz

Gain confidence interpreting Pelvic Masses with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Body

Post-Course Activities

This Power Pack is comprised of 10 unique Pelvic Masses MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Pelvic Masses Cases

Case 5 - This 42-year-old female presents with generalized abdominal pain

<div>HISTORY:&#160;This 42-year-old female presents generalized abdominal pain, swelling and mass. Pelvic mass identified five years prior.(QUIZ ANSWER) WHICH SHOULD BE CONSIDERED?:&#160;All of the above.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: A thin-walled, simple, cystic structure measuring 13.7cm in CC, 10.5cm in AP and 12cm in RL dimensions in the mid pelvis. The mass represents an extraperitoneal location above the urinary bladder and anterior to the uterus. Compressive effect is seen over the uterus and urinary bladder. No solid components or septations within the lesion. Postcontrast images demonstrate no substantive enhancement in the capsule. The soft tissue planes between the cystic mass and ovaries, uterus, bladder and lumbosacral structures are clear indicating that the cyst is paraovarian in nature.&#160;Bilateral ovaries are normal in size. A 1.3cm in diameter simple cyst is seen in the right ovary representing a functional follicular cyst. A 1.8cm in diameter, slightly thick-walled, cystic structure in the left ovary most likely represent a corpus luteal cyst. These findings are consistent with ultrasound findings.&#160;The uterus measures 8.5cm in CC, 5cm in AP and 6.4cm in RL dimensions. Endometrial thickness measures 1.3cm. No cystic or solid mass in the uterine parenchyma. Slightly thick junctional zone without evidence of focal adenomyosis.&#160;Small amount of intraperitoneal free fluid is noted.&#160;Visualized musculoskeletal structures are normal.&#160;Cervix is unremarkable. No endometrial cavity fluid collection or endometrial solid lesions identified.&#160;CONCLUSION:&#160;1. A 13.7cm (CC) x 10.5cm (AP) x 12cm (RL), non-enhancing and likely nonaggressive, nonneoplastic simple, extraperitoneal midline cyst in the pelvis consistent with paraovarian cyst. Surgical investigation is suggested. Other considerations include omental cyst, lymphatic cyst, enteric cyst, mesenteric cyst, mesenteric cyst-ovarian implant syndrome, unlikely are giant peritoneal pseudocyst, nonmalignant serous neoplasm.2. Corpus luteal cyst in the left ovary.&#160;3. Small peritoneal fluid collection.</div>

Case

In this case, which of the following differentials should be considered?