Ovarian endometriomas and diffuse adenomyosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Dysmenorrhea with right lower abdominal pain.

Patient Data

Age: 45 years
Gender: Female

The uterus is diffusely enlarged with circumferential thickening of the endometrium-myometrium junctional zone (17 mm). There are two well-defined right ovarian cystic masses measuring (10x9.5x7.5 cm), and (4.3x4.1x3.8 cm) of high signal intensity on T1WI/T1 fat sat, low signal intensity on T2WI (mainly the largest cyst) with no peripheral enhancement seen on postcontrast sequences.

The left ovary is of normal size, containing small follicles.

Mild effusion is noted in the Douglas pouch.

Case Discussion

MRI features of right ovarian endometriomas with diffuse adenomyosis.

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