Case contributed by Rania Adel Anan


Recent worsening of long-term intermittent pelvic pain. Amenorrhea during the last 6 months.

Patient Data

Age: 20 years
Gender: Female

A large well-defined homogenous unilocular cystic lesion is seen in the deep pelvic region, retro-uterine in location mildly compressing & displacing the uterus anteriorly. It extends to both adnexal regions and abutting both ovaries. It shows diffuse low-level internal echoes—giving the classic “ground glass” appearance. No detected solid nodules or calcifications. Doppler scan revealed no internal vascularity (not shown). It is seen surrounded by a minimal amount of free fluid. It measures about 7.7 x 9 x 6.6 cm.

Case Discussion

Findings are compatible with endometrioma located in the posterior cul-de-sac.

Ground glass appearance is a classic sign of endometrioma appearing as multiple diffuse low-level internal echoes representing repeated episodes of intracystic hemorrhage

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