Endometrioma left ovary or something else

This 32 year old female patient had history of painful menses with location to the left pelvis. 

Ultrasound imaging shows:

Cyst of 4 cms with ground glass internal echoes within it. Color Doppler ultrasound revealed no internal vascularity. 

The differential diagnoses include:

* Endometrioma: This is the most likely diagnosis, especially if the patient is a premenopausal woman. Endometriomas are benign cysts that are caused by the growth of endometrial tissue outside the uterus. They are typically found in the ovaries and can range in size from a few centimeters to several centimeters. On ultrasound, endometriomas appear as cystic lesions with diffuse low-level echoes, giving them a "ground glass" appearance.

* Hemorrhagic cyst: This is another possibility, especially if the patient is experiencing pain. Hemorrhagic cysts are cysts that have been filled with blood. They can occur in women of any age, but they are more common in women who are menstruating. On ultrasound, hemorrhagic cysts appear as cystic lesions with internal echoes that vary in appearance depending on the age of the blood.

* Dermoid cyst: This is a rare type of ovarian cyst that is made up of epidermal tissue. Dermoid cysts can contain a variety of materials, including hair, teeth, and bone. On ultrasound, dermoid cysts appear as cystic lesions with internal echoes that have a heterogeneous appearance.

* Ovarian cancer: This is a less likely diagnosis, but it is still possible. Ovarian cancer is a serious disease that can be fatal if it is not detected early. On ultrasound, ovarian cancer can appear as a cystic lesion with internal echoes, but it can also appear as a solid mass.

The management and prognosis of a left ovary cystic lesion with internal echoes showing ground glass appearance will depend on the underlying diagnosis. As, the diagnosis in this is most likely to be endometrioma, the patient may be treated with pain medication or hormonal therapy. If the diagnosis is a hemorrhagic cyst, the patient may be monitored with ultrasound to see if the cyst resolves on its own. If the diagnosis is a dermoid cyst, the cyst may be removed surgically.

The prognosis in this patient is generally good. Most likely cause being endometrioma of this lesion can be treated successfully. 

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Ultrasound imaging of endometrioma ovary