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Ureteral endometriosis

Case contributed by Gustavo Aguiar
Diagnosis almost certain

Presentation

Hydronephrosis

Patient Data

Age: 40 years
Gender: Female
mri

MRI shows a right hydronephrosis due to paracervical endometriotic implant that involves the distal right ureter.

Annotated image

Paracervical endometriotic implant (arrow) that involves the ureter (*).

Case Discussion

Ureteral endometriosis is the involvement of ureter by endometriotic tissue. There are two types of this condition: intrinsic and extrinsic. Intrinsic ureteral endometriosis is histologically defined by infiltration of the muscularis of the ureteral wall. Extrinsic involvement is more common (80% of cases) and is caused by progressive enclosure of the ureter by endometriotic tissue. Thus, ureteral endometriosis should be considered in any female patient of child-bearing age who has obstructive uropathy attributable to extrinsic obstruction of the distal ureter.

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