Presentation
Severe endometriosis, adenomyosis. Radical surgery
Patient Data
ANTERIOR COMPARTMENT: Normal.
MIDDLE COMPARTMENT:
Uterus: Anteverted 64 mm long with normal morphology. Endometrium 2 mm and regular.
Anterior junctional zone thickening with T2/T1 bright cystic foci, 11 mm - adenomyosis.
Fundal posterior 32 x 2 mm minimal residual T2 dark serosal fibrosis, with minimal superficial
rectosigmoid tethering, unchanged. It contains T1 bright foci, suggesting hemorrhagic
components. Reduced mobility.
Ovaries: Left 12 mm unilocular T1 bright thin-walled cyst with no septa or solid parts –
uncomplicated endometrioma, unchanged. LO tethered to L USL/30 mm of overlying sigmoid.
Right ovary not identified - no right adnexal follicular activity.
Fallopian tubes: superficial tethering only.
POSTERIOR COMPARTMENT: superficial tethering only.
INCIDENTAL FINDINGS: None.
Case Discussion
Solitary 12 mm left endometrioma with superficial rectosigmoid tethering but no bowel deep infiltrating endometriosis. It is important to still report linear fibrotic bowel involvement as "bowel endometriosis" as the referrers may otherwise read the MRI as falsely negative for bowel involvement.
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