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Endometriomas

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Long history of intermittent pelvic pain. Worse these last few days.

Patient Data

Age: 35 years
Gender: Female
ultrasound

Multiple round hypoechoic densities are shown within both ovaries and demonstrate intermediate echogenicity. The largest of these on the right measures 3.5cm, the largest on the left measures 2.6cm. The uterus is normal in size and echogenicity. It is anteverted and mobile. 

Case Discussion

The long history of pelvic pain supports the impressions that these represent endometriomas rather than multiple hemorrhagic cysts. A repeat scan is being organized to confirm that these are stable (thus further supporting the diagnosis of endometriosis).

Alternatively MRI could be performed, which typically demonstrates a shaded appearance on T2.

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