Ovarian endometriomas - bilateral

Case contributed by Bahman Rasuli

Presentation

Chronic pelvic pain and primary infertility.

Patient Data

Age: 35 years
Gender: Female

Two well-defined thin-walled cystic lesions are seen in both ovaries ( right ovary: 27 x 35 x 41 mm, left ovary: 35 x 50 x 55 mm), appearing hyperintense on T1 fat-suppressed sequence, and hypointense on T2W images "shading sign", suggesting endometrioma cysts.

Both ovaries are seen in close proximity to each other behind the uterus "kissing ovaries".

Mild fluid signal density is seen in cul-de-sac space.

Case Discussion

MRI study shows bilateral ovarian endometrioma cysts (chocolate cysts) with T2 shading. The close proximity of both ovaries is known as "kissing ovaries" which is caused by adhesions and is considered a sign of pelvic endometriosis.

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