Follicle, functional or follicular cyst, ovulatory cyst
Definitions
Well-marginated, round or ovoid structure within or at borders of ovary; no solid component
No fat, Ca²⁺, or septa
Thin, imperceptible wall (< 3 mm thick)
May appear more complex after internal hemorrhage
No internal vascularity on color Doppler imaging
Definitions of different cyst types & their sizes vary
Follicle
Generally < 1 cm in diameter
Dominant follicle may measure up to 3 cm
Functional cysts
Corpus luteal cyst
After ovulation, dominant follicle becomes corpus luteal cyst
Usually < 3 cm, though can be much larger
Follicular cyst
Occurs when normal mature follicle fails to ovulate/involute
Usually 3-10 cm
Hemorrhagic cyst
Hemorrhage occurs into one of above
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Abdelmeguid Y et al: Huge ovarian cyst in a neonate with classical 21-hydroxylase deficiency. Clin Pediatr Endocrinol. 30(1):57-60, 2021
Kitami M et al: "Follow the fallopian tube": a technique to improve sonographic identification of ovaries in children. J Clin Ultrasound. 49(1):33-7, 2021
Xac MC et al: Benign, borderline, and malignant pediatric adnexal masses: a ten-year review. J Pediatr Adolesc Gynecol. 34(4):454-61, 2021
Kodikara H et al: Massive, benign, cystic ovarian tumors: a technical modification for minimally invasive resection. J Pediatr Surg.56(2):417-9, 2020
Magistrado L et al: Paratubal cyst recurrence in children and adolescents. J Pediatr Adolesc Gynecol. 33(6):649-51, 2020
Peeraully R et al: Effect of surgical specialty on management of adnexal masses in children and adolescents: an 8-year single-center review. J Pediatr Adolesc Gynecol. 33(1):89-92, 2020
Riaz M et al: Van Wyk Grumbach syndrome. J Coll Physicians Surg Pak. 30(12):1332-4, 2020
Caprio MG et al: Ultrasonographic and multimodal imaging of pediatric genital female diseases. J Ultrasound. 22(3):273-89, 2019
Schallert EK et al: Physiologic ovarian cysts versus other ovarian and adnexal pathologic changes in the preadolescent and adolescent population: US and surgical follow-up. Radiology. 292(1):172-8, 2019
Gonzalez DO et al: Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Curr Opin Obstet Gynecol. 29(5):289-94, 2017
Naffaa L et al: Imaging of acute pelvic pain in girls: ovarian torsion and beyond☆. Curr Probl Diagn Radiol. 46(4):317-29, 2017
Trotman GE et al: Rate of oophorectomy for benign indications in a children's hospital: influence of a gynecologist. J Pediatr Adolesc Gynecol. 30(2):234-8, 2017
Madenci AL et al: Preoperative risk stratification of children with ovarian tumors. J Pediatr Surg. 51(9):1507-12, 2016
Bronstein ME et al: A meta-analysis of B-mode ultrasound, Doppler ultrasound, and computed tomography to diagnose pediatric ovarian torsion. Eur J Pediatr Surg. 25(1):82-6, 2015
Cho MJ et al: Ovarian cyst aspiration in the neonate: minimally invasive surgery. J Pediatr Adolesc Gynecol. 28(5):348-53, 2015
Ngo AV et al: Pediatric ovarian torsion: a pictorial review. Pediatr Radiol. 45(12):1845-55; quiz 1842-4, 2015
Asăvoaie C et al: Ovarian and uterine ultrasonography in pediatric patients. Pictorial essay. Med Ultrason. 16(2):160-7, 2014
Papic JC et al: Management of neonatal ovarian cysts and its effect on ovarian preservation. J Pediatr Surg. 49(6):990-3; discussion 993-4, 2014
Youngster M et al: Utility of ultrasound in the diagnosis of polycystic ovary syndrome in adolescents. Fertil Steril. 102(5):1432-8, 2014
Tessiatore P et al: When to operate on ovarian cysts in children? J Pediatr Endocrinol Metab. 25(5-6):427-33, 2012
Muolokwu E et al: The incidence and surgical management of paratubal cysts in a pediatric and adolescent population. J Pediatr Surg. 46(11):2161-3, 2011
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
Bekiesińska-Figatowska M et al: Magnetic resonance imaging as a diagnostic tool in case of ovarian masses in girls and young women. Med Sci Monit. 13 Suppl 1:116-20, 2007
Brandt ML et al: Ovarian cysts in infants and children. Semin Pediatr Surg. 14(2):78-85, 2005
Borders RJ et al: Computed tomography of corpus luteal cysts. J Comput Assist Tomogr. 28(3):340-2, 2004
Strickland JL: Ovarian cysts in neonates, children and adolescents. Curr Opin Obstet Gynecol. 14(5):459-65, 2002
Cohen HL et al: Ovarian cysts are common in premenarchal girls: a sonographic study of 101 children 2-12 years old. AJR Am J Roentgenol. 159(1):89-91, 1992
Surratt JT et al: Imaging of pediatric ovarian masses. Radiographics. 11(4):533-48, 1991
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Follicle, functional or follicular cyst, ovulatory cyst
Definitions
Well-marginated, round or ovoid structure within or at borders of ovary; no solid component
No fat, Ca²⁺, or septa
Thin, imperceptible wall (< 3 mm thick)
May appear more complex after internal hemorrhage
No internal vascularity on color Doppler imaging
Definitions of different cyst types & their sizes vary
Follicle
Generally < 1 cm in diameter
Dominant follicle may measure up to 3 cm
Functional cysts
Corpus luteal cyst
After ovulation, dominant follicle becomes corpus luteal cyst
Usually < 3 cm, though can be much larger
Follicular cyst
Occurs when normal mature follicle fails to ovulate/involute
Usually 3-10 cm
Hemorrhagic cyst
Hemorrhage occurs into one of above
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Abdelmeguid Y et al: Huge ovarian cyst in a neonate with classical 21-hydroxylase deficiency. Clin Pediatr Endocrinol. 30(1):57-60, 2021
Kitami M et al: "Follow the fallopian tube": a technique to improve sonographic identification of ovaries in children. J Clin Ultrasound. 49(1):33-7, 2021
Xac MC et al: Benign, borderline, and malignant pediatric adnexal masses: a ten-year review. J Pediatr Adolesc Gynecol. 34(4):454-61, 2021
Kodikara H et al: Massive, benign, cystic ovarian tumors: a technical modification for minimally invasive resection. J Pediatr Surg.56(2):417-9, 2020
Magistrado L et al: Paratubal cyst recurrence in children and adolescents. J Pediatr Adolesc Gynecol. 33(6):649-51, 2020
Peeraully R et al: Effect of surgical specialty on management of adnexal masses in children and adolescents: an 8-year single-center review. J Pediatr Adolesc Gynecol. 33(1):89-92, 2020
Riaz M et al: Van Wyk Grumbach syndrome. J Coll Physicians Surg Pak. 30(12):1332-4, 2020
Caprio MG et al: Ultrasonographic and multimodal imaging of pediatric genital female diseases. J Ultrasound. 22(3):273-89, 2019
Schallert EK et al: Physiologic ovarian cysts versus other ovarian and adnexal pathologic changes in the preadolescent and adolescent population: US and surgical follow-up. Radiology. 292(1):172-8, 2019
Gonzalez DO et al: Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Curr Opin Obstet Gynecol. 29(5):289-94, 2017
Naffaa L et al: Imaging of acute pelvic pain in girls: ovarian torsion and beyond☆. Curr Probl Diagn Radiol. 46(4):317-29, 2017
Trotman GE et al: Rate of oophorectomy for benign indications in a children's hospital: influence of a gynecologist. J Pediatr Adolesc Gynecol. 30(2):234-8, 2017
Madenci AL et al: Preoperative risk stratification of children with ovarian tumors. J Pediatr Surg. 51(9):1507-12, 2016
Bronstein ME et al: A meta-analysis of B-mode ultrasound, Doppler ultrasound, and computed tomography to diagnose pediatric ovarian torsion. Eur J Pediatr Surg. 25(1):82-6, 2015
Cho MJ et al: Ovarian cyst aspiration in the neonate: minimally invasive surgery. J Pediatr Adolesc Gynecol. 28(5):348-53, 2015
Ngo AV et al: Pediatric ovarian torsion: a pictorial review. Pediatr Radiol. 45(12):1845-55; quiz 1842-4, 2015
Asăvoaie C et al: Ovarian and uterine ultrasonography in pediatric patients. Pictorial essay. Med Ultrason. 16(2):160-7, 2014
Papic JC et al: Management of neonatal ovarian cysts and its effect on ovarian preservation. J Pediatr Surg. 49(6):990-3; discussion 993-4, 2014
Youngster M et al: Utility of ultrasound in the diagnosis of polycystic ovary syndrome in adolescents. Fertil Steril. 102(5):1432-8, 2014
Tessiatore P et al: When to operate on ovarian cysts in children? J Pediatr Endocrinol Metab. 25(5-6):427-33, 2012
Muolokwu E et al: The incidence and surgical management of paratubal cysts in a pediatric and adolescent population. J Pediatr Surg. 46(11):2161-3, 2011
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
Bekiesińska-Figatowska M et al: Magnetic resonance imaging as a diagnostic tool in case of ovarian masses in girls and young women. Med Sci Monit. 13 Suppl 1:116-20, 2007
Brandt ML et al: Ovarian cysts in infants and children. Semin Pediatr Surg. 14(2):78-85, 2005
Borders RJ et al: Computed tomography of corpus luteal cysts. J Comput Assist Tomogr. 28(3):340-2, 2004
Strickland JL: Ovarian cysts in neonates, children and adolescents. Curr Opin Obstet Gynecol. 14(5):459-65, 2002
Cohen HL et al: Ovarian cysts are common in premenarchal girls: a sonographic study of 101 children 2-12 years old. AJR Am J Roentgenol. 159(1):89-91, 1992
Surratt JT et al: Imaging of pediatric ovarian masses. Radiographics. 11(4):533-48, 1991
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