Ovarian endometriomas, hematosalpinx and unicornuate uterus

Case contributed by Ammar Haouimi


Cyclic pain increasing over time.

Patient Data

Age: 20 years
Gender: Female

A right unicornuate uterus with a distended rudimentary left uterine horn containing blood products of high signal intensity on T1 fat sat, not communicating with the uterine cavity, indicating a functional non-communicating horn.

Distended and tortuous left fallopian tube with fluid content of high signal intensity on T1WI and T1WI fat sat and less hyperintense on T2WI (blood products), indicating a hematosalpinx.

The left ovary shows a large cystic mass (8.5 x 6 cm) of high signal intensity on T1WI fat saturation, low signal intensity on T2WI with a shading sign and no peripheral enhancement on post-contrast T1WI fat sat sequences.

The right ovary shows multiple small follicles as well as a small cystic lesion (1 cm) of same signal intensity of that of the left side.

Minimal effusion was seen in Douglas pouch.

Case Discussion

MRI appearances of bilateral ovarian endometriomas (larger on the left) with left hematosalpinx in a patient with a unicornuate uterus and left functional non-communicating uterine horn (class IIb of Müllerian duct anomaly classification).

Additional contributor: A Ramdani MD.

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