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Endometriomas - bilateral

Case contributed by Dr Ali Abougazia

Presentation

Primary infertility.

Patient Data

Age: 30 years
Gender: Female
MRI

Both ovaries are seen in close proximity to each other behind the uterus (kissing ovaries) with the left ovary being enlarged by virtue of an irregular 5 X 4.6 X 4 cm cyst that elicits hyperintense T1 and mildly hyperintense T2 / T2 FS signals with a center of isointense T1 and bright T2 / T2 FS signals. In addition is has a thick low signal wall. A right ovarian cyst of similar features is seen measuring 2.5 X 2 X 2 cm with hypointense internal shadows (T2 shading).

Case Discussion

Bilateral ovarian hemorrhagic cysts, impressive of bilateral endometrioma (chocolate cysts). The close proximity of both ovaries is known as "kissing ovaries" which is caused by adhesions and is considered a sign of pelvic endometriosis.

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