A 27-year-old woman being evaluated for primary infertility has a transvaginal scan showing an elongated, tubular, well-defined cystic structure in the right adnexa with incomplete internal septations and a folded 'S' configuration, clearly separate from both ovaries. The most likely diagnosis is:
- A Haemorrhagic ovarian cyst
- B Paraovarian cyst
- C Hydrosalpinx ✓
- D Peritoneal inclusion cyst
Correct answer: C. Hydrosalpinx
Explanation
C hydrosalpinx is a dilated fluid-filled fallopian tube appearing as a tubular or pear-shaped adnexal cyst with incomplete septations formed by infolding of the tubal walls, often giving a cogwheel appearance in acute salpingitis and a waist sign when compressed. Its key discriminators are the tubular shape and its separation from the ipsilateral ovary, which excludes an ovarian cyst. Peritoneal inclusion cysts occur in women with adhesions and conform to the pelvic shape, enclosing the ovary rather than lying apart from it.
Reference: Rumack's Diagnostic Ultrasound, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.