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Ask Dr.M.D.Mazumdar Your Own Question
Dr.M.D.Mazumdar, Doctor
Category: OB GYN
Satisfied Customers: 9031
Experience:  MD (Obst&Gynecology)
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Hello, I would like a second opinion (already spoke to Dr

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I would like a second opinion (already spoke to Dr Owen who was very helpful) on an ovarian cyst. What does hypoechoic mean?

Welcome and thank you for your question.

The term ' Hypoechoic' is used in ultrasound to indicate an area of the body through which the sound waves pass easily - this is seen with liquids. In ultrasound the sound waves are sent into the body and once they strike an organ and are reflected back , recorded. In case of solid structures, more sound waves reflect back and are thus termed as ' hyperehoic'. In case of liquid bodies, the sound waves pass through and less are reflected back - so they are hypoechoic.

If your ovarian cyst has been reported as Hypoechoic, then it means that it contains fluid and is not a solid mass.

I hope this helps.
Customer: replied 4 years ago.


So hypechoic does not mean solid tissue? May I post a couple photos and report for your opinion on this cyst?


Yes, hypoechoic does not mean solid tissue.

Please go ahead and post the images.
Customer: replied 4 years ago.

I really want to post these photos. When I upload the photo and hit reply, it gives me an error that says access denied. Never had this happen on this site. Let me try again


You can upload the photos to a freesite like and then post the links here. That should work.
Customer: replied 4 years ago.

Ok, let me try that. This is so strange. I've posted lots of things on here and never had this problem. Let me try really quick. One sec please. Sorry


Customer: replied 4 years ago.

So sorry about that. Thanks for your patience. Photobucket would not work for me. Not sure what's going on. They worked here. Are you able to see these 5 images:

http:[email protected]/?saved=1


Customer: replied 4 years ago.

I loaded one more on flickr, image 0709 if you wouldn't mind looking at that one as well?

Let me check that out.
Customer: replied 4 years ago.


Customer: replied 4 years ago.

I'm not sure if you replied but I just got an email that you replied but there's nothing posted except where I replied "thanks" after you said you'd check it out


I have just checked the images.

you do have a ovarian cyst - it contains only fluid and no solid areas - which is a good sign since solid areas can indicate malignant tissue.

The cysts also contain fine debris - likely to be either old blood or cellular debris. Blood is sometimes present in the cyst due to a condition called endometriosis but in this condition, the debris will look more evenly present throughout the cyst and more thicker.

Your ultrasound shows a simple ovarian cyst.

I hope this helps.
Customer: replied 4 years ago.

It's confusing, the report says it's complex. I see also it has the little bright white echogenic foci (I think that's the right description). I thought the internal echoes/grey stuff throughout meant it was complex?

I also thought it was strange how lacking in info. the radiologist report is. There's nothing descript in it. It mentions it's a complex cyst but nothing about what makes it complex....internal echoes, septations, nodularity, etc. Is this normal that the radiologist would just state a cyst looks complex in appearance with no other info?

The report does mention a complex cyst but the images does not show any solid areas - there are bright foci which are likely to be cellular debris.

A complex cyst usually means that there is a mass of clearly identified solid structure together with the fluid component.

In your cases, images no 0707, 0692 - show completely clear cysts. Image no 0690 - however shows a indentation on the right side of teh cyst - possibly this has been identified as a solid mass by the radiologist. I do not think this is a part of teh cyst.

Customer: replied 4 years ago.

Thank you. Can complex cyst also mean it has internal echoes? When you say you don't think 0690 is part of the cyst (indentation), not sure I know what you mean.

And the above are my last questions.

Customer: replied 4 years ago.

And I know only histopathology (?) will only tell for sure but do you think this looks like a cancerous ovarian mass?

If you check image no - 0690, you will see that there is a solid mass on the right side which seem to be indenting the fluid area - it is possible that this is what the radiologist meant when he said complex but i do not think that this indentation is a part of the cyst.

And I do not think, going by the images, that this is not malignant.
Sorry, I meant that I do not think that is is malignant.
Dr.M.D.Mazumdar and 2 other OB GYN Specialists are ready to help you
Customer: replied 4 years ago.

Thanks for taking a look.

Customer: replied 4 years ago.
I'm sorry, do you mind explaining you said you don't think this solid area/indentation is a part of the cyst? Do you mean you think it's likely not something growing from the cyst wall like a huge nodule?
Yes, that is what I meant - I do not think that this is growing from the side of the cyst wall. It looks more like something outside the cyst but which seems to be inside the cyst due to the angle of the ultrasound probe.
Customer: replied 4 years ago.
Could it be my ovary? I guess I'm
Asking if that's more likely the ovary rather than some other type of growth?
Yes, the cyst is from the ovary, not some other growth.
Customer: replied 4 years ago.
I meant the object that's causing that right sided cyst wall indentation, couldn't it be the ovary causing the cyst wall indentation rather than like a solid growth of some sort next to the cyst?
Oh yes, it probably is part of the ovary causing the indentation.