Presentation
cyclic painful swelling of the pelvic wall. Past history of cesarean section 15 years ago
Patient Data
There is a soft tissue mass with spiculated margin in the mid-pelvic wall at the level of the cesarean scar, in contact with the rectus abdominis muscles, measuring (5.3 x 5 x 4.3 cm). It elicits an is signal to the muscle on T1/T2 with a central area of high signal on T1/T1 fast sat and T2. The postcontrast sequences show moderate and heterogeneous enhancement.
Normal appearance of the uterus. The cesarean scar is well-visualized at the isthmus on the sagittal T2 sequence.
Normal appearance of both ovaries showing small follicles.
Minimal effusion in Douglas pouch.
Case Discussion
MRI features are most consistent with scar endometriosis (biopsy-proven)
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