Differential Diagnosis for 22-year-old Para 01 with Abdomino-Pelvic Mass
Based on History and Physical Examination
- Single Most Likely Diagnosis
- Ovarian Cyst: The patient's presentation of a growing pelvic mass associated with pain, particularly when walking, and the initial diagnosis of an ovarian mass, makes ovarian cyst a highly plausible diagnosis. The fact that she is of reproductive age and has a history of regular menstrual cycles also supports this diagnosis.
- Other Likely Diagnoses
- Uterine Fibroid: Although less common in younger women, uterine fibroids can present with pelvic masses and pain, especially if they are large or pedunculated. The absence of urinary or bowel symptoms does not rule out this diagnosis.
- Dermoid Cyst (Mature Cystic Teratoma): These are common in young women and can grow large enough to cause discomfort or pain, especially if they become torsioned.
- Do Not Miss Diagnoses
- Ovarian Torsion: Although the patient does not present with acute severe pain, ovarian torsion is a surgical emergency that can occur with any ovarian mass. It's crucial to consider this diagnosis due to its potential for severe consequences if missed.
- Ovarian Cancer: While less likely in a young woman, ovarian cancer must be considered, especially if the mass is solid, fixed, or associated with other systemic symptoms. The patient's lack of weight loss, early satiety, or other systemic symptoms does not entirely rule out this diagnosis.
- Rare Diagnoses
- Germ Cell Tumor: These are rare ovarian tumors that can occur in young women. They might present with a pelvic mass and could be considered in the differential, especially if other more common diagnoses are ruled out.
- Lymphoma: Although extremely rare, lymphoma can present with pelvic masses, particularly if there is lymphadenopathy. The patient's lack of systemic symptoms (e.g., weight loss, fever) and the absence of mentioned lymphadenopathy make this less likely but not impossible.
Each of these diagnoses should be considered in the context of the patient's age, symptoms, and physical examination findings, with further investigation and imaging studies (like ultrasound, CT, or MRI) necessary to narrow down the differential diagnosis and guide management.