A 35-year-old woman with endometriosis has a 6-cm left ovarian cyst containing thick chocolate-brown fluid. Histologically the cyst wall is lined by endometrial-type glands and stroma with hemosiderin-laden macrophages. This lesion is called:

• A Endometrioma (chocolate cyst) ✓
• B Mucinous cystadenoma
• C Dermoid cyst (mature cystic teratoma)
• D Granulosa cell tumor

Explanation

An endometrioma (commonly called a 'chocolate cyst') is an ovarian cyst formed by ectopic endometrial tissue responding to cyclical hormonal changes with repeated bleeding; the blood degrades to produce the characteristic dark brown, thick fluid resembling melted chocolate. Histology confirms endometrial glands and stroma with hemosiderin deposits from old hemorrhage. Mucinous cystadenoma contains mucin-producing columnar epithelium. Dermoid cysts contain skin appendages, hair, and sebaceous material. Granulosa cell tumors are sex-cord stromal tumors associated with estrogen secretion.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.