A dominant 2.0-cm ovarian cyst in a menarche patient is most likely which structure?

• A. Graafian Follicle
• B. Corpus Luteum
• C. Corpus Albicans
• D. Hemorrhagic Cyst

Answer: (A)

In adolescence, a dominant, simple ovarian cyst around 2 cm most likely represents a Graafian follicle, the mature follicle just before ovulation. This follicle grows to about 1–2 cm and appears on ultrasound as a thin-walled, anechoic cyst, often seen as the dominant structure during the follicular phase. After ovulation, the corpus luteum forms and can appear as a cystic structure too, but it’s typically associated with the luteal phase and may have thicker walls or internal echoes if there is luteal hemorrhage. The corpus albicans is a scar from a regressed corpus luteum and would not present as a simple dominant cyst. A hemorrhagic cyst would usually show internal echoes from blood. So the presentation fits a Graafian follicle.