Adenomyosis and endometriotic cysts

Case contributed by Bahman Rasuli
Diagnosis almost certain


Chronic pelvic pain and menometrorrhagia.

Patient Data

Age: 40 years
Gender: Female

Enlarged uterus measuring about 9 x 11 x 14 cm. Marked thickening of uterus junctional zone and posterior body with multiple small high T2 foci reflecting diffuse adenomyosis.

Bilateral ovarian cysts, measuring about 3.5 cm on the left and 2.5 cm on the right with a characteristic T2 shading sign ( hyperintense on T1 and hypointense on T2) without postcontrast enhancement and water restriction on DWI images, in keeping with ovarian endometrioma.

Case Discussion

The uterus shows features of diffuse-type adenomyosis. Bilateral endometriotic cysts are noted with T2 shading signs.

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