Presentation
Per vaginal bleeding after intercourse, irregular menstruation with a 45-50 day cycle.
Patient Data
During the TVS examination, a thick-walled cystic lesion was observed on the right ovary measuring 34.3 × 28.0 × 37.3 mm. The cyst contained a solid mural nodule with clear uneven contours measuring 18.3 × 14.0 mm. The solid component within the cyst showed internal vascularization, as seen on color Doppler.
The presence of internal solid vascular components inside the cyst supports the diagnosis of serous cystadenocarcinoma over serous cystadenoma.
Case Discussion
Ovarian serous cystadenomas are generally thin-walled cysts that are typically unilocular and may have papillary projections.
In contrast, the malignant version appears as either unilocular or multilocular cystic masses with papillary projections, central vascularization, and thick walls with septations.