Cystic endometrial hyperplasia

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Episodes of vaginal bleeding in postmenopausal patient.

Patient Data

Age: 65 years
Gender: Female
This study is a stack
Sagittal
T2
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Axial
T2
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Coronal
T2
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Axial
T1
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Axial
DWI
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Axial
ADC
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Axial T1
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
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Info

Retroverted retroflexed uterus with a well-defined mass of the endometrial cavity containing numerous tiny cysts of high signal T2 with no restricted diffusion. The postcontrast sequences show moderate heterogeneous enhancement. No underlying myometrial invasion is seen.

Small periurethral cysts (probably Skene duct cysts).

Case Discussion

MRI features a well-defined mass of the endometrial cavity containing numerous tiny cysts with no obvious endometrial invasion (cystic endometrial hyperplasia vs endometrial cancer).

The patient went on to have a total hysterectomy with a histopathological exam that confirms the diagnosis of cystic endometrial hyperplasia.

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