Endometriosis - abdominal wall

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Intermittent lower abdominal wall swelling with pain, especially during menstrual cycles.

Patient Data

Age: 40 years
Gender: Female

A relatively well-defined heterogeneous enhancing lesion measuring about 20 x 35 x 40 mm at the inferior aspect of the left rectus abdominis muscle.

It displays heterogeneous signal intensity on T1WI and T2WI with hyperintense areas on both T1 and T2 fat-sat images suggestive of blood products. Smaller cystic changes are also seen.           

Case Discussion

Endometriosis of the abdominal wall or C-section scar usually presents with a swelling associated with cyclic pain. MRI is a more specific imaging modality that helps in locating other sites of endometriosis.

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