Differential Diagnosis for a Pulsating Mass Near the Uterus on Obstetrical Ultrasound
- Single Most Likely Diagnosis
- Uterine leiomyoma (fibroid) with a degenerative change or a pedunculated fibroid: This is a common finding in women of reproductive age and can appear as a pulsating mass due to its vascular nature.
- Other Likely Diagnoses
- Ovarian cyst or tumor with significant vascularity: Ovarian masses can be highly vascular and may appear pulsating on ultrasound due to blood flow.
- Ectopic pregnancy: Although less common, an ectopic pregnancy can present as a pulsating mass near the uterus, especially if it has significant blood flow.
- Uterine arteriovenous malformation (AVM): A rare vascular anomaly that can cause a pulsating mass appearance on ultrasound due to abnormal blood flow.
- Do Not Miss Diagnoses
- Ectopic pregnancy with significant bleeding: This is a life-threatening condition that requires immediate attention. A pulsating mass near the uterus could be indicative of an ectopic pregnancy with active bleeding.
- Uterine rupture or dehiscence: Although rare, a pulsating mass could be a sign of uterine rupture or dehiscence, especially in women with a history of uterine surgery.
- Ovarian torsion: A twisted ovarian cyst or tumor can cause a pulsating mass appearance due to compromised blood flow and should be considered a medical emergency.
- Rare Diagnoses
- Uterine sarcoma: A rare malignant tumor of the uterus that can appear as a pulsating mass due to its vascular nature.
- Parasitic fibroid: A rare type of fibroid that can detach from the uterus and attach to other organs, potentially appearing as a pulsating mass.
- Vascular malformations (e.g., arteriovenous fistula): Rare vascular anomalies that can cause a pulsating mass appearance on ultrasound due to abnormal blood flow.