Follicular Cyst Formation — When the Dominant Follicle Does Not Rupture
Placeholder: ovulation fails, follicle keeps growing into a thin-walled cyst.
- 2.5–8 cm: Typical size (placeholder range)
- Thin, smooth: Wall thickness (placeholder note)
- Mid-cycle: Onset (placeholder timing)
- Often none: Symptoms (placeholder note)
Follicular growth and failed rupture
Placeholder: LH surge insufficient, follicle continues accumulating fluid.
Ultrasound appearance
Placeholder: simple anechoic unilocular cyst, thin regular wall.
Corpus Luteum Cyst Formation — Persistence After Ovulation
Placeholder: corpus luteum fails to regress, fills with fluid or blood.
- 3–10 cm: Typical size (placeholder range)
- Higher than follicular: Rupture risk (placeholder note)
- Progesterone secreting: Hormone (placeholder note)
- Luteal phase: Timing (placeholder timing)
Hemorrhagic transformation
Placeholder: internal bleeding gives complex, cobweb-pattern ultrasound texture.
Clinical relevance
Placeholder: can delay menses, mimic ectopic pregnancy presentation.
Functional Cyst Spontaneous Resolution — Regression Over Successive Cycles
Placeholder: most functional cysts shrink and disappear within two to three cycles.
- ~90%: Resolution rate (placeholder figure)
- 1–3 cycles: Time to resolve (placeholder range)
- Repeat ultrasound: Follow-up (placeholder note)
- Rarely needed: Intervention (placeholder note)
Fluid resorption mechanism
Placeholder: cyst wall thins, fluid gradually reabsorbed by stroma.
Confirming resolution
Placeholder: interval imaging confirms shrinkage before discharge from follow-up.
Pathological Cyst Persistence — Dermoid and Endometrioma Behavior
Placeholder: unlike functional cysts, these structures persist and often enlarge.
- Fat, hair, teeth: Dermoid content (placeholder note)
- Ground-glass echoes: Endometrioma look (placeholder note)
- Does not occur: Regression (placeholder note)
- Slow, progressive: Growth (placeholder note)
Why these do not resolve
Placeholder: fixed tissue or organized blood does not reabsorb.
Imaging red flags
Placeholder: septations, solid components, and internal blood flow raise concern.
Placeholder: persistence beyond three cycles favors pathological over functional origin.
Monitoring vs Intervention — Choosing the Right Pathway
Placeholder: size, persistence, and features guide watchful waiting versus surgery.
- <5 cm, simple: Watch threshold (placeholder note)
- Complex or growing: Refer threshold (placeholder note)
- Serial ultrasound: Tool (placeholder note)
- CA-125 if concerning: Marker (placeholder note)
Decision criteria
Placeholder: combine size, morphology, symptoms, and cycle persistence.
Escalation pathway
Placeholder: unresolved or suspicious cysts move to surgical evaluation.