GENITOURINARY IMAGING: Female Pelvis
Case Author: Courtney Coursey Moreno, MD, Emory Healthcare
History
35-year-old woman with occasional pain in the right lower quadrant.
Imaging Findings
Axial T1-weighted fat-saturated MR image (A) shows a 1.5-cm mass (arrow) with intermediate to high signal intensity in the subcutaneous fat of the right lower quadrant that extends into the right rectus abdominis muscle. Axial T2-weighted MR image (B) shows low signal intensity in the mass (arrow). Axial contrast-enhanced T1-weighted MR image (C) shows uniform enhancement of the mass (arrow).
- Endometrioma
- Hematoma
- Hernia
- Primary or secondary malignancy
Diagnosis
Endometrioma
Teaching Points
Endometrioma in a surgical scar is rare and occurs in 1% of patients who have undergone obstetric or gynecologic surgery. Patients with endometrioma in a surgical scar may present with localized cyclical pain. A fine-needle aspiration cytologic examination can be performed to confirm the diagnosis of endometrioma. If symptomatic, abdominal wall scar endometriomas often are removed surgically.
Suggested Readings
Veda P, Srinivasaiah M. Incisional endometriosis: diagnosed by fine needle aspiration cytology. J Lab Physicians 2010; 2:117–120
Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surg 1996; 6:1042–1044
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