EP26.24: Cervical macrocyst: a masquerader!

We report a 42-year-old woman with a history of primary infertility for the past 9 years referred for a routine pelvic scan. No other contributing medical history was present. On transvaginal scan a large hypoechoic lesion with thick isoechoic rim was seen in the region of the cervix which showed central low level internal echoes of varying echogenicity. For better delineation of the location of the lesion ultrasound following introduction of Gel into the vagina (Gel Vaginal Sonography) was performed. The lesion was located within the posterior lip of the cervix which not only the expansion of the lip but also caused a mass effect and thinning of the anterior lip of the cervix. Mobility of the internal contents of the lesion was observed on the application of pressure with the probe. On power Doppler there was perilesional vascularity along the capsule of the above mass. Both ovaries were normal. Based on the Ultrasound findings possibilities of Endometriotic or Nabothian cyst with mobile turbid contents and cervical fibroid with cystic degeneration were entertained. Patient was taken up for surgery and enucleation of the lesion was performed. Histopathologic examination revealed a cervical leiomyoma with hydropic degeneration. This case highlights the finding that a cervical fibroid with complete degenerative changes can mimic a cyst which can pose a clinical dilemma. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.