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Dermoid cyst or Hydatid cyst
Dear Members,
Today I've scanned a 22 yrs female pt. and got the following usg feature(attached).
Short history:
C/C:
1. Pain in the right side of the lower abdomen for 1 day.
2. Vomiting for severals times.
3. Irregular intermittent low grade fever for some days.
P/H:
Married but husband is away.
M/H:
Regular. Ongoing menstruation.
O/E:
Temp: N
Inv. reports:
Not available.
Usg finding:
A large [8.0cm(L) x 7.2cm(T) x 6.8cm(AP)] complex cyst noted in the mid-line just above the uterus
So, what it looks like? A Dermoid cyst(Cystic Teratoma) or Hydatid cyst???
Views: 131
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Image0620.jpg, 847 KB
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Replies to This Discussion
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Permalink Reply by Marcos Tawil MD on -
Think first on Corpus Luteum or Endometrioma ... scan again in 2-3 weks. How about free fluid on cul-de-sac?
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Permalink Reply by Marcos Tawil MD on
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Marcos Tawil MD said:Think first on Corpus Luteum or Endometrioma ... scan again in 2-3 weks. How about free fluid on cul-de-sac?
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Permalink Reply by Hasan Md. Mehedi Harun on -
Thanks Sir for the reply.
As I've mentioned the location of the pathology is just above the uterus so free fluid on cul-de-sac can be excluded.
Can endometrioma have so anechoic appearance(without uniformly distributed internal echos) ?
Yes Corpus luteum cyst may be a D/D.
One of my teacher also suggested that it may be a twisted ovarian cyst where there is internal hemorrhage(old).
What is u'r remark about that?
Again with regards
Dr. Mehedi
Marcos Tawil MD said:Think first on Corpus Luteum or Endometrioma ... scan again in 2-3 weks. How about free fluid on cul-de-sac?
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Permalink Reply by Marcos Tawil MD on
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There is a broad range of ultrasound appearances of endometriomas. Diffuse, low level internal echoes occur in 95% of endometriomas. Hyperechoic wall foci and multilocularity also point towards an endometrioma.
Diagnostic accuracy may be enhanced by Doppler flow studies where blood flow in endometriomas is usually pericystic with a resistive index above 0.45
Re-scanning on the menstrual cycle may be the best idea.
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Permalink Reply by Dr MM Nurus shafi on -
Thanks Dr Mehedi. Your image has a significantly large KB taking a long time to develop in our screen . You can easily convert it into a smaller KB in the range of just 20-30 KB by changing it into JPG form which you can learn from a local computer operator. As far as hydatid cyst is concerned, a chronic one will show wall calcification & an acute one , an internal wavy soft tissue curvilinear structure. Dermoid or CL cyst is possible & we have to wait fot 06 wks to see whether it resolves. Endometrioma is also possible as Dr Tiwal rightly has pointed.
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Permalink Reply by Kal Sakhel on
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Agree with Dr Tawil. Consider a hemorrhagic CL, or dermoid in the differential. A repeat US after 6 weeks from initial scan may be useful. How is she doing clinically? Please let us know your findings.
It is advisable not to include the patient's name or any identifying information on the scanned images.
Thanks for posting this interesting case.
KS
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Permalink Reply by essam el gabbas on -
Kal Sakhel said:
Agree with Dr Tawil. Consider a hemorrhagic CL, or dermoid in the differential. A repeat US after 6 weeks from initial scan may be useful. How is she doing clinically? Please let us know your findings.
It is advisable not to include the patient's name or any identifying information on the scanned images.
Thanks for posting this interesting case.
KS
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Permalink Reply by Syed Amir Gilani on -
i would like to include serous cystadenoma in differential diagnosis as there seem to be a septa??I do agree with H/CYST AND DERMOID TOO IN DD.
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