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Follicular Cyst
Marc S. Tubay, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Follicular cyst (FC)
          • Synonyms

            • Physiologic cyst
            • Dominant follicle
          • Definitions

            • Hormone-dependent functional ovarian cyst
            • Develops during follicular phase of menstrual cycle and persists into luteal phase

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • MR Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                          2. Ross EK et al: Incidental ovarian cysts: When to reassure, when to reassess, when to refer. Cleve Clin J Med. 80(8):503-14, 2013
                                          3. Vargas HA et al: MRI of ovarian masses. J Magn Reson Imaging. 37(2):265-81, 2013
                                          4. Laing FC et al: US of the ovary and adnexa: to worry or not to worry? Radiographics. 32(6):1621-39; discussion 1640-2, 2012
                                          5. Langer JE et al: Imaging of the female pelvis through the life cycle. Radiographics. 32(6):1575-97, 2012
                                          6. Brown DL et al: Adnexal masses: US characterization and reporting. Radiology. 254(2):342-54, 2010
                                          7. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Top Magn Reson Imaging. 21(4):213-23, 2010
                                          8. Levine D et al: Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology. 256(3):943-54, 2010
                                          9. Takeuchi M et al: Manifestations of the female reproductive organs on MR images: changes induced by various physiologic states. Radiographics. 30(4):1147, 2010
                                          10. Potter AW et al: US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients. Radiographics. 28(6):1645-59, 2008
                                          11. Shwayder JM: Pelvic pain, adnexal masses, and ultrasound. Semin Reprod Med. 26(3):252-65, 2008
                                          12. Tamai K et al: MR features of physiologic and benign conditions of the ovary. Eur Radiol. 16(12):2700-11, 2006
                                          13. Patel MD et al: The likelihood ratio of sonographic findings for the diagnosis of hemorrhagic ovarian cysts. J Ultrasound Med. 24(5):607-14; quiz 615, 2005
                                          14. Swire MN et al: Various sonographic appearances of the hemorrhagic corpus luteum cyst. Ultrasound Q. 20(2):45-58, 2004
                                          15. Guerriero S et al: The diagnosis of functional ovarian cysts using transvaginal ultrasound combined with clinical parameters, CA125 determinations, and color Doppler. Eur J Obstet Gynecol Reprod Biol. 110(1):83-8, 2003
                                          16. Jain KA: Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med. 21(8):879-86, 2002
                                          17. Miele V et al: Hemoperitoneum following ovarian cyst rupture: CT usefulness in the diagnosis. Radiol Med (Torino). 104(4):316-21, 2002
                                          18. Pretorius ES et al: Magnetic resonance imaging of the ovary. Top Magn Reson Imaging. 12(2):131-46, 2001
                                          19. Dill-Macky MJ et al: Ovarian sonography: In Ultrasonography in Obstetrics and Gynecology. 4th ed. Philadelphia: Saunders. 863-4, 2000
                                          20. MacKenna A et al: Clinical management of functional ovarian cysts: a prospective and randomized study. Hum Reprod. 15(12):2567-9, 2000
                                          21. Borgfeldt C et al: Transvaginal sonographic ovarian findings in a random sample of women 25-40 years old. Ultrasound Obstet Gynecol. 13(5):345-50, 1999
                                          22. Hertzberg BS et al: Adnexal ring sign and hemoperitoneum caused by hemorrhagic ovarian cyst: pitfall in the sonographic diagnosis of ectopic pregnancy. AJR Am J Roentgenol. 173(5):1301-2, 1999
                                          23. Hertzberg BS et al: Ovarian cyst rupture causing hemoperitoneum: imaging features and the potential for misdiagnosis. Abdom Imaging. 24(3):304-8, 1999
                                          24. Guerriero S et al: Sonographic differential diagnosis of persistent ovarian cysts. Ultrasound Obstet Gynecol. 12(1):74-5, 1998
                                          25. Sickler GK et al: Free echogenic pelvic fluid: correlation with hemoperitoneum. J Ultrasound Med. 17(7):431-5, 1998
                                          26. Outwater EK et al: Normal ovaries and functional cysts: MR appearance. Radiology. 198(2):397-402, 1996
                                          27. Atri M et al: Endovaginal sonographic appearance of benign ovarian masses. Radiographics. 14(4):747-60; discussion 761-2, 1994
                                          28. Okai T et al: Transvaginal sonographic appearance of hemorrhagic functional ovarian cysts and their spontaneous regression. Int J Gynaecol Obstet. 44(1):47-52, 1994
                                          29. Bass IS et al: The sonographic appearance of the hemorrhagic ovarian cyst in adolescents. J Ultrasound Med. 3(11):509-13, 1984
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Follicular cyst (FC)
                                                  • Synonyms

                                                    • Physiologic cyst
                                                    • Dominant follicle
                                                  • Definitions

                                                    • Hormone-dependent functional ovarian cyst
                                                    • Develops during follicular phase of menstrual cycle and persists into luteal phase

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                                                                  2. Ross EK et al: Incidental ovarian cysts: When to reassure, when to reassess, when to refer. Cleve Clin J Med. 80(8):503-14, 2013
                                                                                  3. Vargas HA et al: MRI of ovarian masses. J Magn Reson Imaging. 37(2):265-81, 2013
                                                                                  4. Laing FC et al: US of the ovary and adnexa: to worry or not to worry? Radiographics. 32(6):1621-39; discussion 1640-2, 2012
                                                                                  5. Langer JE et al: Imaging of the female pelvis through the life cycle. Radiographics. 32(6):1575-97, 2012
                                                                                  6. Brown DL et al: Adnexal masses: US characterization and reporting. Radiology. 254(2):342-54, 2010
                                                                                  7. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Top Magn Reson Imaging. 21(4):213-23, 2010
                                                                                  8. Levine D et al: Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology. 256(3):943-54, 2010
                                                                                  9. Takeuchi M et al: Manifestations of the female reproductive organs on MR images: changes induced by various physiologic states. Radiographics. 30(4):1147, 2010
                                                                                  10. Potter AW et al: US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients. Radiographics. 28(6):1645-59, 2008
                                                                                  11. Shwayder JM: Pelvic pain, adnexal masses, and ultrasound. Semin Reprod Med. 26(3):252-65, 2008
                                                                                  12. Tamai K et al: MR features of physiologic and benign conditions of the ovary. Eur Radiol. 16(12):2700-11, 2006
                                                                                  13. Patel MD et al: The likelihood ratio of sonographic findings for the diagnosis of hemorrhagic ovarian cysts. J Ultrasound Med. 24(5):607-14; quiz 615, 2005
                                                                                  14. Swire MN et al: Various sonographic appearances of the hemorrhagic corpus luteum cyst. Ultrasound Q. 20(2):45-58, 2004
                                                                                  15. Guerriero S et al: The diagnosis of functional ovarian cysts using transvaginal ultrasound combined with clinical parameters, CA125 determinations, and color Doppler. Eur J Obstet Gynecol Reprod Biol. 110(1):83-8, 2003
                                                                                  16. Jain KA: Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med. 21(8):879-86, 2002
                                                                                  17. Miele V et al: Hemoperitoneum following ovarian cyst rupture: CT usefulness in the diagnosis. Radiol Med (Torino). 104(4):316-21, 2002
                                                                                  18. Pretorius ES et al: Magnetic resonance imaging of the ovary. Top Magn Reson Imaging. 12(2):131-46, 2001
                                                                                  19. Dill-Macky MJ et al: Ovarian sonography: In Ultrasonography in Obstetrics and Gynecology. 4th ed. Philadelphia: Saunders. 863-4, 2000
                                                                                  20. MacKenna A et al: Clinical management of functional ovarian cysts: a prospective and randomized study. Hum Reprod. 15(12):2567-9, 2000
                                                                                  21. Borgfeldt C et al: Transvaginal sonographic ovarian findings in a random sample of women 25-40 years old. Ultrasound Obstet Gynecol. 13(5):345-50, 1999
                                                                                  22. Hertzberg BS et al: Adnexal ring sign and hemoperitoneum caused by hemorrhagic ovarian cyst: pitfall in the sonographic diagnosis of ectopic pregnancy. AJR Am J Roentgenol. 173(5):1301-2, 1999
                                                                                  23. Hertzberg BS et al: Ovarian cyst rupture causing hemoperitoneum: imaging features and the potential for misdiagnosis. Abdom Imaging. 24(3):304-8, 1999
                                                                                  24. Guerriero S et al: Sonographic differential diagnosis of persistent ovarian cysts. Ultrasound Obstet Gynecol. 12(1):74-5, 1998
                                                                                  25. Sickler GK et al: Free echogenic pelvic fluid: correlation with hemoperitoneum. J Ultrasound Med. 17(7):431-5, 1998
                                                                                  26. Outwater EK et al: Normal ovaries and functional cysts: MR appearance. Radiology. 198(2):397-402, 1996
                                                                                  27. Atri M et al: Endovaginal sonographic appearance of benign ovarian masses. Radiographics. 14(4):747-60; discussion 761-2, 1994
                                                                                  28. Okai T et al: Transvaginal sonographic appearance of hemorrhagic functional ovarian cysts and their spontaneous regression. Int J Gynaecol Obstet. 44(1):47-52, 1994
                                                                                  29. Bass IS et al: The sonographic appearance of the hemorrhagic ovarian cyst in adolescents. J Ultrasound Med. 3(11):509-13, 1984