Diffuse adenomyosis - bilateral fibrothecoma

Case contributed by Dr Ammar Haouimi

Presentation

Referred by her gynecologist for follow-up.

Patient Data

Age: 60 years
Gender: Female

The MRI sequences demonstrate:

  • enlarged uterus with diffuse thickening of the  junctional zone endometrium-myometrium (18-25 mm) of intermediate signal on T1, homogeneous low signal intensity on T2 with foci of high signal within,  indicating menstrual hemorrhage into the ectopic endometrial tissues
  • numerous small intramural and subserosal leiomyomas are noted
  • bilateral well-defined ovarian masses of intermediate signal on T1, low signal on T2 with a punctate central area of high signal (mainly on the left) and moderate enhancement on postcontrast sequences.
  • irregular circumferential thickening with enhancement of the sigmoid colon, and restricted diffusion on DWI/ADC. Infiltration of the mesocolon with thickening and enhancement of the adjacent peritoneal reflections

Case Discussion

The patient is known to have diffuse adenomyosis with numerous small leiomyomas and bilateral ovarian masses probably ovarian fibrothecomas. The sigmoid tumor was an incidental finding.

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