Endometriotic cysts

Case contributed by Dr Varun Babu

Presentation

Patient with known endometriosis.

Patient Data

Age: 40 years
Gender: Female
MRI

Uterus is anteverted, measures 8.0 x 3.4 x 3.6 cm (CC x AP x TR). Normal junctional zone. Normal endometrium with thickness of 6 mm. Two intramural fibroids seen in posterior wall largest 9.4 x 6.6 mm. 9 mm anterior wall subserous fibroid.

Right ovary is adherent to right lateral uterine wall, is replaced by a cyst of size 5.4 x 6.5 x 6.8 cm (120 cc). Cyst shows T2 shading with hyperintense T1 signal. No mural nodules. Smooth walls.  Thin smooth internal septum. No post contrast enhancement.

Left ovary is adherent to left lateral uterine wall, shows a cyst that measures 3.2 x 4.0 x 4.5 cm, (28 cc). Cyst shows T2 shading with hyperintense T1 signal. No mural nodules. Smooth walls.  No post contrast enhancement.

Moderate free fluid in pouch of Douglas. No pelvic lymphadenopathy. Normal pelvic bones. No other pelvic deposits.

Conclusion

  • Bilateral endometriotic cysts (right larger than left). Both ovaries are independently adherent to the uterus.

  • Two posterior intramural and one anterior subserosal uterine fibroid.

  • Moderate pelvic free fluid.

  • No other pelvic or abdominal deposits.

Case Discussion

Endometriosis can result in recurrent cyst formation in ovaries, as in this case with T2 shading typical of the recurrent hemorrhage. Ovaries tend to adhere to uterus. Always look for other pelvic endometriotic deposits. They are horrible to have if one has not conceived yet, as they distort the fallopian tubes. 

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Case information

rID: 61918
Published: 24th Jul 2018
Last edited: 14th Aug 2019
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Vivid Diagnostic Centre

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