Origin | Associated clinical features | Ultrasonographic features |
Ovarian origin |
Follicular cyst | - Common in neonates and perimenarchal/menarcheal adolescents
| - Simple (clear fluid filled), or
- Complex (containing debris, septae, solid components; echogenic wall)
|
Corpus luteal cyst | | - Complex (internal echoes)
|
Endometrioma ("chocolate cyst") | - Rare in adolescents
- Bilateral in 33%
| - Complex (unilocular cyst with echogenic debris)
|
Para-ovarian origin |
Ectopic pregnancy | - Abdominal pain and vaginal bleeding
- Increasing beta-hCG
| - Pregnancy at ectopic site
- Extraovarian adnexal mass
|
Hydrosalpinx or pyosalpinx | | - Dilated tubular structure adjacent to ovary, may have incomplete septations
|
Paraovarian/paratubal cysts (eg, mesonephric cysts, cysts of the broad ligament) | - Often asymptomatic
- Abdominal pain or distension
- Increases risk of tubal torsion
| - Simple cysts
- Size can range from a few millimeters to 15 cm or larger
|
Tubo-ovarian abscess | - Usually a complication of PID; may result from intra-abdominal spread
- Abdominopelvic pain
- Fever
- Purulent cervical discharge
- Cervical motion tenderness
- Leukocytosis
| - Complex
- Multilocular
- Obscure normal adnexal anatomy
- Contains speckled fluid with internal echoes (inflammatory debris)
|