Question

A 15 year old otherwise healthy female presents to her family physician with right lower quadrant abdominal pain. Although the pain waxes and wanes, it reaches a 7/10 on the pain scale, and ibuprofen has been ineffective. Menarche occurred at age 10 and her menses have always been regular at 26 day cycles. The patient is not sexually active. LMP was 2 weeks ago. Bimanual exam appreciates normal size ovaries, but the patient experiences pain on palpation of the right adnexae. An abdominal ultrasound reveals a 5 cm smooth, thin walled, unilocular cystic structure on the right ovary. Urine pregnancy test is negative and WBC is normal. What is the most likely diagnosis?

A. PCOS
B. Desmoid tumor
C. Endometriosis
D. Physiological ovarian cyst
E. Tubo-ovarian abscess

Answer 1

The 15-year-old female with abdominal pain and an ultrasound showing a 5 cm unilocular ovarian cyst likely has a Physiological ovarian cyst, which generally resolves on its own and does not require treatment.

Step-by-step explanation:

The most likely diagnosis for a 15-year-old female who presents with right lower quadrant abdominal pain, a history of regular menses, and a finding of a 5 cm smooth, thin-walled, unilocular cystic structure on the right ovary is a Physiological ovarian cyst. Physiological ovarian cysts, such as follicular cysts or corpus luteum cysts, are common occurrences in the menstrual cycle and often resolve on their own without treatment. Other options like PCOS, desmoid tumors, endometriosis, and tubo-ovarian abscess have distinguishing features that are not mentioned in the patient's presentation, such as irregular periods in PCOS or fever and elevated WBC count in tubo-ovarian abscess.