Focal uterine adenomyosis

Case contributed by Ammar Haouimi


Vaginal bleeding.

Patient Data

Age: 50 years
Gender: Female

The uterus is enlarged with focal thickening of the endometrium-myometrium junctional zone at the corporeofundal region (thickness=46 mm), seen as an ill-defined area within the myometrium of intermediate signal on T1 and T2  with foci of high signal (ectopic endometrial tissue within the myometrium). A mass effect is noted on the endometrial cavity which contains hyperintense fluid.

Small Nabothian cysts are noted.

Case Discussion

MRI of features most consistent with focal adenomyosis

The main differential diagnosis is a uterine leiomyoma:

  • peripheral displacement of the vessels on color Doppler
  • +/- calcification.

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