Scar endometriosis

Case contributed by Dr Ammar Haouimi

Presentation

Cyclic painful swelling of the right paramedian pelvic wall. History of three cesarian sections.

Patient Data

Age: 35 years
Gender: Female
MRI

The MRI sequences demonstrate:

  • circumferential thickening of the endometrial-myometrial junctional zone (maximum thickness = 18 mm) in keeping with adenomyosis
  • swelling the right rectus abdominis muscle cystic areas within of intermediate to high signal on T1, T1 fat sat and T2 with moderate heterogeneous enhancement, most likely in keeping with an ectopic endometrial tissue

Case Discussion

The MRI features are most consistent with scar endometriosis within the rectus abdominis muscle with diffuse adenomyosis in a patient with a history of three cesarian sections.

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