This diagnostic image is a transvaginal ultrasound scan of a right adnexal mass, identified in clinical context as an ovarian dermoid cyst (struma ovarii). The image demonstrates a large, complex cystic structure with multiple internal thin septations. The cyst exhibits a predominantly hypoechoic internal fluid appearance, interspersed with focal areas of heterogeneous echogenicity and echogenic components, suggestive of solid elements or specialized tissue within the cyst. Dotted electronic calipers and plus-sign markers indicate two-dimensional measurements of the lesion: a vertical length of 10.5 cm and a diagonal length of 8.60 cm. This ultrasound is used in gynecology and obstetrics to evaluate adnexal masses for signs of complexity, such as septations and solid components, which inform the differential diagnosis between benign functional cysts and germ cell tumors or other neoplasms. The educational focus is on the ultrasonographic characterization of complex ovarian pathology.

This diagnostic ultrasound image in the pelvic region displays a large, complex adnexal mass measuring approximately 15x12 cm. The mass exhibits a multicystic appearance characterized by multiple internal septations and cystic compartments of varying sizes. The internal compartments are primarily anechoic, consistent with fluid-filled spaces, while the septations and certain peripheral areas show increased echogenicity, suggesting thickened walls or solid components. Measurement calipers are visible on the screen, delineating the extent of the mass within the adnexal space. This finding is clinically significant in the context of an 18-week pregnancy and acute abdominal pain, where the differential diagnosis includes adnexal torsion or a large ovarian cyst (such as a mucinous cystadenoma). The image demonstrates the displacement of adjacent pelvic structures and the characteristic lack of obvious malignant sonographic features, such as highly vascular solid papillary projections, despite its significant size.

This diagnostic ultrasound image displays a transverse view of an adnexal mass, categorized as a unilocular-solid cyst. The primary feature is a large, predominantly anechoic cystic cavity containing fluid. Arising from the internal wall is a prominent, irregular papillary projection with intermediate echogenicity. Quantitative analysis is provided via electronic calipers: the solid projection measures approximately 32.12 mm in its longest axis (1 D) and 16.98 mm in height (2 D). According to the IOTA (International Ovarian Tumor Analysis) framework, the presence of a solid papillary component within a unilocular cyst increases the suspicion for borderline tumors or malignant serous carcinomas. The clinical context notes that while this specific image (B) represents a borderline serous carcinoma, such findings can visually mimic benign cystadenofibromas, necessitating detailed assessment of vascularity and papillary morphology for differential diagnosis in gynecologic oncology.

This grayscale transvaginal ultrasound image in the sagittal plane (labeled SAG LT ADNEXA) demonstrates a large, complex left adnexal mass. The mass is primarily cystic and multilocular, characterized by anechoic fluid-filled spaces separated by thin septations. A distinct, hyperechoic solid component is visible within the cyst wall (circumscribed by a yellow circle), exhibiting an irregular internal echotexture compared to the surrounding fluid. The outer margins of the cystic portion appear relatively smooth and well-defined. The findings are categorized under the Ovarian-Adnexal Imaging-Reporting and Data System (O-RADS) as score 4, indicating an intermediate risk of malignancy (10% to <50%). This imaging is clinically significant for the evaluation of potential ovarian neoplasms, such as cystadenoma or malignant tumors, in a symptomatic patient.