Concern Over Cystic Lesions: Seeking Clarification
Greetings, I’m a 23-year-old female recently diagnosed with adenomyosis and polycystic ovarian syndrome following an MRI examination. While I have a scheduled consultation with my doctor in a week, I find myself anxious for clarity on certain findings from the MRI report, which I am sharing below. The report indicates the presence of: - A thicc-walled cystic lesion exhibiting peripheral wall enhancement, approximately 2 by 1.6 cm in size, located in the right ovary, with noted thin internal septation and irregularities in the internal mucosal structure. - A smaller cyst, measuring about 2 cm in diameter, also in the right ovary, displaying thin internal septation. My primary concern regards the thick-walled cystic lesion: could it be benign, or should I be alarmed, indicating a need for further evaluation by my gynecologist? I understand that smaller cysts are generally not a cause for concern, but I wonder if this applies only to those that are uniformly shaped and possess thinner walls. The MRI was performed to evaluate potential endometriosis. A previous transvaginal ultrasound ruled out deep infiltrating endometriosis, prompting the MRI to ensure no abnormalities were overlooked, especially given that my calprotectin level was significantly elevated at over 1000, despite a colonoscopy revealing no signs of inflammation, along with reports of resistance detected externally from the colon suggesting the possibility of endometriosis. While I await my appointment, I would greatly appreciate any insights into these findings. Moreover, the MRI results also highlighted mild pelvic congestion and a small amount of free fluid in the pouch of Douglas (POD). --- Background Health Issues: I experience postural orthostatic tachycardia syndrome (POTs) and chronic hypotension.
Answers (1)
2/6/2026, 2:00:54 PM
OpenHealth AI
Thank you for sharing your concerns regarding your MRI findings, especially as they relate to adenomyosis and polycystic ovarian syndrome (PCOS). It’s understandable to feel anxious, and I’m here to help clarify your situation.
Main Points:
- Thick-Walled Cystic Lesion: This could potentially be benign, but it requires careful evaluation.
- Smaller Cyst: Generally less concerning if it’s simple and has thin walls.
- Awaiting Follow-Up: Your upcoming consultation should provide clarity and a treatment plan.
Explanation:
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Thick-Walled Cystic Lesion:
- The presence of a thick-walled cystic lesion with peripheral enhancement can sometimes indicate a benign condition, like a functional cyst, but other possibilities exist, such as endometriomas (associated with endometriosis) or even tumors. The irregularities noted inside the cyst are also factors that need to be evaluated by your gynecologist.
-
Smaller Cyst:
- Smaller cysts that are unilocular (single chamber) and have thin walls often resolve on their own and are usually not a cause for concern, particularly in the context of PCOS.
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Pelvic Congestion and Free Fluid:
- Mild pelvic congestion can be common in those with adenomyosis and can result from hormonal changes, and the fluid found in the pouch of Douglas (POD) is often benign, especially if minimal. However, it should be monitored.
Next Steps:
-
Monitoring Symptoms:
- Keep track of any symptoms you may be experiencing, such as pain, changes in menstrual cycles, or any other related issues.
-
Educate Yourself:
- Familiarize yourself with adenomyosis and PCOS, as understanding these conditions can help you and your doctor discuss your results more effectively.
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Prepare Questions for Your Doctor:
- Write down any specific questions you have about your MRI findings, treatments, and management options for your symptoms.
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Manage Anxiety:
- Consider mindfulness or relaxation techniques, as stress can exacerbate physical symptoms. Practicing these before your appointment might help ease your concerns.
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Follow-Up on Recommendations:
- After your doctor consultation, make sure to follow through with any tests or monitoring they suggest.
Remember, while it's natural to feel anxious, most ovarian cysts are benign, and your healthcare team will provide the best guidance tailored to your situation. If urgent symptoms arise before your appointment, such as severe pain, contact a healthcare provider immediately.
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