Presentation
Pelvic pain.
Patient Data
MRI shows an endometriotic lesion in the rectosigmoid junction that shows a "mushroom cap" sign. There is another endometriotic lesion in the posterior uterine serosa extending to anterior rectal wall.
Mild thickening of the junctional zone of the uterus and small areas of cystic change consistent with adenomyosis, and right ovarian endometrioma are also noted
The low-signal-intensity base of the mushroom is the endometric lesion (asterisk), whereas the high-signal-intensity cap represents the mucosa and submucosa (arrows), which are displaced into the bowel lumen.
Case Discussion
The MR imaging features of solid rectosigmoid endometriosis include a “mushroom cap” sign, which is considered a specific finding of solid invasive endometriosis of the rectosigmoid colon on T2-weighted MR images
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