Case contributed by Dr Mostafa El-Feky


Pelvic pain

Patient Data

Age: 30 years
Gender: Female

Bilateral multiloculated adnexal cystic lesions measuring 6.4 x 5.2 cm and 5.3 x 4 cm in maximum dimensions on the right and left sides respectively. Almost all locules show T2 shading reflecting chronic hemorrhagic content with thin hypointense walls. The larger of them showed T2 dark spot sign on the left side. These cysts show no definite internal soft tissue component identified.

Case Discussion

This case represents multiple pelvic cysts, some of them showed high T1 signal with T2 shading suggestive of multiple endometriomas. It also demonstrates T2 dark spot sign which is a black dot adherent to cyst wall seen in T2 images as a result of chronic hemorrhage. It helps differentiating endometrioma from a functional hemorrhagic ovarian cyst.

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