What is the diagnosis for a patient with abdominal and pelvic computed tomography (CT) scan results showing a cyst-like low-density solid lesion in the left adnexa, with symptoms of cramping and pelvic pain, and a history of previous gastroplasty (stomach surgery) and refusal of gynecological referral?

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Differential Diagnosis for Pelvic Pain and Adnexal Mass

  • Single Most Likely Diagnosis
    • Ovarian cyst: The presence of a 2.5 x 2 cm cyst-like low-density solid lesion in the left adnexa is highly suggestive of an ovarian cyst, which is a common cause of pelvic pain and can be benign or malignant.
  • Other Likely Diagnoses
    • Endometriosis: Given the patient's symptoms of cramping and pelvic pain, endometriosis is a possible diagnosis, although the CT scan did not show any definitive evidence of endometriosis.
    • Adnexal torsion: Although the CT scan did not show any evidence of adnexal torsion, it is still a possible diagnosis, especially if the patient's symptoms worsen or change.
    • Pelvic inflammatory disease (PID): PID is a possible diagnosis, although the CT scan did not show any evidence of inflammation in the floor of the pelvis or the adnexa.
  • Do Not Miss Diagnoses
    • Ovarian torsion: Ovarian torsion is a medical emergency that requires prompt attention. Although the CT scan did not show any evidence of torsion, it is still a possible diagnosis, especially if the patient's symptoms worsen or change.
    • Ectopic pregnancy: Although the patient's history does not suggest pregnancy, ectopic pregnancy is a possible diagnosis that should not be missed, as it can be life-threatening.
    • Appendicitis: Although the CT scan did not show any evidence of appendicitis, it is still a possible diagnosis, especially if the patient's symptoms worsen or change.
  • Rare Diagnoses
    • Ovarian cancer: Although the CT scan showed a cyst-like lesion in the left adnexa, ovarian cancer is a rare diagnosis that should be considered, especially if the patient's symptoms persist or worsen.
    • Dermoid cyst: A dermoid cyst is a rare type of ovarian cyst that can cause pelvic pain and should be considered in the differential diagnosis.
    • Adnexal malignancy: Although rare, adnexal malignancy is a possible diagnosis that should be considered, especially if the patient's symptoms persist or worsen.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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