Adenomyosis with endometrioma

Case contributed by Dr Ahmed Almuslim
Ultrasound

Complex avascular adnexal mass.

MRI

The complex cystic mass has low T1WI centrally and high signal peripherally. The peripheral high T1WI is not suppressed on fat sat. Complex cystic mass has heterogenous high T2WI centrally and a peripheral dark rim. The cyst has high T2WI content that is not suppressed in fat saturation. The peripheral high T1WI rim of the ovarian mass is seen.

Diffuse uterine junctional zone thickening is in keeping with adenomyosis.

Case Discussion

The left ovary shows complex cystic mass that has low T1WI, high T2WI central content. The key finding for the diagnosis is the high T1WI, dark T2WI rim which is not suppressed by fat saturation. These are in keeping with blood and in the presence of adenomyosis, this is highly suggestive of an endometrioma.

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Case information

rID: 6753
Published: 16th Aug 2009
Last edited: 10th Jun 2018
System: Gynaecology
Inclusion in quiz mode: Included

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