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US/CT scan results: 'dermoid' cyst, free pelvic fluid

I'm 35, no kids

US 9/29 after a ER trip with LL pelvic pain (mild pain a month prior).

Findings: complex predominantly echogenic right adnexal mass with measures 2.4 X 1.8 X 2.1. There is a rind of ovarian stroma around the mass as well as a unilocular cyst with measures 2.3 X 2.2 X 1.9 cm. The left adnexa measures 3.0 X 2.6 X 2.7 cm and contains a unilocular mildly complex follicle or cyst which measures 2.1 X 1.5 X 1.5 cm. Mildly increased volume of free fluid in the right pelvis and cul-de-sac. Conclusions: Unilocular right adnexal cysts associated with mildly increased volume of complex free fluid in the cul de sac, most c/w leakage from the identified cyst. Advise 6 week follup for resolution. Small complex left ovarian follicle or cyst. Advise 6 week follup for resolution. Complex right adnexal mass with features c/w cystic teratoma or dermoid cyst. Advise 3-month follow-up exam in 3 months for stability.

GI dr. then ordered CT scan 10/26. Results: There are multiple low-density liver lesions between 1-2 mm that do not enhance on delayed images consistent with small cysts. There is a 5 mm enhancing lesion on the right heptatic lobe segment consistent with a hemangioma.
There is a 4X2.7 cm right adnexal mass which contains coarse calcifications consistent with a mature cystic teratoma. Moderate amount of free pelvic ascites.

Followed up w/ GYN; have another US on 12/8. I'm very worried (GI dr prescribed meds for my obvious anxiety); am having some general pelvic pain. Any thoughts about treatment plan (laparascopy/MRI?) and about significance of free pelvic fluid?
1 Responses
242604 tn?1328121225
Hi There,
It sounds like you are having a good and careful evaluation. I agree with a follow up ultrasound. Most free fluid comes from  ruptured ovarian cysts. The fluid gets absorbed. If pain, cysts, and fluid persist, that is a good indication to take a look by laparoscopy
best wishes to you

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