Presentation
Chronic pelvic pain.
Patient Data
The MRI sequences demonstrate:
Enlarged uterus with diffuse thickening of the junctional zone endometrium-myometrium (15 mm) in keeping with diffuse adenomyosis
Well-defined right ovarian complex cystic mass with fat-fluid level. The fatty component is attenuated on fat sat sequences. A floating ball is noted within the fluid component of intermediate signal on both T1 and T2 with no enhancement seen on postcontrast sequences
small unilocular cyst of the right ovary (2 cm) most likely a serous inclusion cyst
Case Discussion
MRI features of diffuse uterine adenomyosis and ovarian dermoid cyst with fat-fluid level and intracystic floating ball sign which is uncommon but pathognomonic for ovarian dermoid cyst.
mature teratoma in old women is rarely reported in the literature with a high risk of malignant transformation over the age of 50 1,2.
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