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Functional Ovarian Cyst
Priyanka Jha, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Follicular cyst (FC)
              • Corpus luteum cyst (CLC)
            • Definitions

              • Follicle < 3 cm: Anechoic cyst in premenopausal woman
                • Follicular cyst (FC) forms from persistent follicle, ovulation does not occur
                  • Associated with elevated serum estrogen
              • Corpus luteum: Thick-walled cyst ≤ 3 cm
                • May have crenulated inner margins, internal echoes, & intense peripheral color Doppler flow
                • CLC forms from graafian follicle following ovulation

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Strachowski LM et al: O-RADS ultrasound: a user's guide, from the AJR special series on radiology reporting and data systems. AJR Am J Roentgenol. 216(5):1150-65, 2021
                                        2. Jha P et al: Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm. Abdom Radiol (NY). 45(10):3213-7, 2020
                                        3. Khati NJ et al: Imaging of benign adnexal disease. Radiol Clin North Am. 58(2):257-73, 2020
                                        4. Patel MD et al: Management of incidental adnexal findings on CT and MRI: a white paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 17(2):248-54, 2020
                                        5. Patel-Lippmann KK et al: Comparison of international ovarian tumor analysis simple rules to society of radiologists in ultrasound guidelines for detection of malignancy in adnexal cysts. AJR Am J Roentgenol. 214(3):694-700, 2020
                                        6. Stein EB et al: Contemporary guidelines for adnexal mass imaging: a 2020 update. Abdom Radiol (NY). ePub, 2020
                                        7. Levine D et al: Simple adnexal cysts: SRU Consensus Conference update on follow-up and reporting. Radiology. 293(2):359-71, 2019
                                        8. Andreotti RF et al: Ovarian-adnexal reporting lexicon for ultrasound: a white paper of the ACR Ovarian-Adnexal Reporting and Data System Committee. J Am Coll Radiol. 15(10):1415-29, 2018
                                        9. Rosenkrantz AB et al: US of incidental adnexal cysts: adherence of radiologists to the 2010 Society of Radiologists in Ultrasound guidelines. Radiology. 271(1):262-71, 2014
                                        10. Ghosh E et al: Recommendations for adnexal cysts: have the Society of Radiologists in Ultrasound Consensus Conference guidelines affected utilization of ultrasound? Ultrasound Q. 29(1):21-4, 2013
                                        11. Valentin L et al: Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol. 41(1):80-9, 2013
                                        12. Faschingbauer F et al: Subjective assessment of ovarian masses using pattern recognition: the impact of experience on diagnostic performance and interobserver variability. Arch Gynecol Obstet. 285(6):1663-9, 2012
                                        13. Alcázar JL et al: Assessment of cyst content using mean gray value for discriminating endometrioma from other unilocular cysts in premenopausal women. Ultrasound Obstet Gynecol. 35(2):228-32, 2010
                                        14. 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
                                        15. Timmerman D et al: Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 341:c6839, 2010
                                        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

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Follicular cyst (FC)
                                                    • Corpus luteum cyst (CLC)
                                                  • Definitions

                                                    • Follicle < 3 cm: Anechoic cyst in premenopausal woman
                                                      • Follicular cyst (FC) forms from persistent follicle, ovulation does not occur
                                                        • Associated with elevated serum estrogen
                                                    • Corpus luteum: Thick-walled cyst ≤ 3 cm
                                                      • May have crenulated inner margins, internal echoes, & intense peripheral color Doppler flow
                                                      • CLC forms from graafian follicle following ovulation

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Strachowski LM et al: O-RADS ultrasound: a user's guide, from the AJR special series on radiology reporting and data systems. AJR Am J Roentgenol. 216(5):1150-65, 2021
                                                                              2. Jha P et al: Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm. Abdom Radiol (NY). 45(10):3213-7, 2020
                                                                              3. Khati NJ et al: Imaging of benign adnexal disease. Radiol Clin North Am. 58(2):257-73, 2020
                                                                              4. Patel MD et al: Management of incidental adnexal findings on CT and MRI: a white paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 17(2):248-54, 2020
                                                                              5. Patel-Lippmann KK et al: Comparison of international ovarian tumor analysis simple rules to society of radiologists in ultrasound guidelines for detection of malignancy in adnexal cysts. AJR Am J Roentgenol. 214(3):694-700, 2020
                                                                              6. Stein EB et al: Contemporary guidelines for adnexal mass imaging: a 2020 update. Abdom Radiol (NY). ePub, 2020
                                                                              7. Levine D et al: Simple adnexal cysts: SRU Consensus Conference update on follow-up and reporting. Radiology. 293(2):359-71, 2019
                                                                              8. Andreotti RF et al: Ovarian-adnexal reporting lexicon for ultrasound: a white paper of the ACR Ovarian-Adnexal Reporting and Data System Committee. J Am Coll Radiol. 15(10):1415-29, 2018
                                                                              9. Rosenkrantz AB et al: US of incidental adnexal cysts: adherence of radiologists to the 2010 Society of Radiologists in Ultrasound guidelines. Radiology. 271(1):262-71, 2014
                                                                              10. Ghosh E et al: Recommendations for adnexal cysts: have the Society of Radiologists in Ultrasound Consensus Conference guidelines affected utilization of ultrasound? Ultrasound Q. 29(1):21-4, 2013
                                                                              11. Valentin L et al: Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol. 41(1):80-9, 2013
                                                                              12. Faschingbauer F et al: Subjective assessment of ovarian masses using pattern recognition: the impact of experience on diagnostic performance and interobserver variability. Arch Gynecol Obstet. 285(6):1663-9, 2012
                                                                              13. Alcázar JL et al: Assessment of cyst content using mean gray value for discriminating endometrioma from other unilocular cysts in premenopausal women. Ultrasound Obstet Gynecol. 35(2):228-32, 2010
                                                                              14. 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
                                                                              15. Timmerman D et al: Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 341:c6839, 2010