Abdominal Cystic Mass for Evaluation

Abstract

A 24-year-old married woman presented to the outpatient clinic with abdominal pain and weight and appetite loss lasting a few months. The abdomen appeared soft on clinical examination, with a palpable midline mass eliciting fluid thrill, corresponding to 32 weeks gestation. Speculum examination revealed a retroverted uterus, healthy cervix, and posterior fornix of the vagina with minimal mucous discharge. On examination of the anterior fornix of the vagina, a cystic mass was seen compressing the bladder and the structures below. Abdominal ultrasound revealed a large cystic lesion in the midline with multiple internal echoes, measuring 20.1 × 11.5 × 13.1 cm in the abdominopelvic region. The lesion seemed to arise from the left ovary as the left ovary could not be visualized separately. On magnetic resonance imaging (MRI), a large abdominopelvic cystic mass seemed to arise from the left ovary with multiple thin septations, measuring 23.0 × 9.0 × 18.0 cm noted in the midline, displacing and compressing the adjacent structures. The classical stained glass appearance of the large cystic lesion was non-satisfactorily visualized on short tau inversion recovery images.

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