Atypical deep infiltrating endometriosis

Case contributed by Dr Lukas Valkovic

Presentation

Young female with pelvic pain. US and clinical examination found a mass in rectovaginal septum.

Patient Data

Age: 29
Gender: Female
Modality: MRI

Mass in cul-de-sac region with a somewhat glandular appearance, surrounded by fibrosis and with a retraction effect on cervix and rectosigmoid colon. No signs of bleeding detected, with only one small hemorrhagic cyst on right ovary. 

Case Discussion

This is a rather atypical case of endometriosis with a large mass infiltrating the uterus (cervix and isthmus) and rectosigmoid colon. There is no evidence of bleeding within the expansion, which is a typical sign of endometrioma. However, there is fibrosis with retraction effect. Glandular appearance is also very rare in endometriosis. Transvaginal biopsy confirmed the diagnosis of endometriosis. 

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Case Information

rID: 44470
Case created: 22nd Apr 2016
Last edited: 28th Sep 2016
System: Gynaecology
Inclusion in quiz mode: Included

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