Case contributed by Dr Mostafa Mahmoud El Feky


Pelvic pain

Patient Data

Age: 30
Gender: Female

MRI pelvis

Bilateral multi-loculated adnexal cystic lesions measuring 6.4 x 5.2 and 5.3 x 4 cm in maximum dimensions on the right and left sides respectively. Almost all loculae showed T2 shading reflecting hemorrhagic content. Associated with thickened uterosacral ligaments as well as stranding of the parametria bilaterally. The larger of them showed T2 dark spot sign. These cysts show no definite internal soft tissue component identified with thin hypointense walls.

Case Discussion

This case represents multiple pelvic cysts, some of them showed high T1 signal with T2 shading suggestive of multiple endometriomas. This case 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 haemorrhagic ovarian cyst.

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Case information

rID: 54255
Published: 6th Jul 2017
Last edited: 9th Jul 2017
System: Gynaecology
Inclusion in quiz mode: Included

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