Atypical deep infiltrating endometriosis
Young female with pelvic pain. US and clinical examination found a mass in rectovaginal septum.
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Mass in cul-de-sac region with a somewhat glandular appearance, surrounded by fibrosis and with a retraction effect on cervix and rectosigmoid colon. No signs of bleeding detected, with only one small hemorrhagic cyst on right ovary.
This is a rather atypical case of endometriosis with a large mass infiltrating the uterus (cervix and isthmus) and rectosigmoid colon. There is no evidence of bleeding within the expansion, which is a typical sign of endometrioma. However, there is fibrosis with retraction effect. Glandular appearance is also very rare in endometriosis. Transvaginal biopsy confirmed the diagnosis of endometriosis.