Presentation
Metrorrhagea. History of secondary infrertility of 12 years. Enlarged uterus on ultrasound exam.
Patient Data
Enlarged uterus with diffuse thickening of the endometrial-myometrial junctional zone up to 40 mm of intermediate signal on T1, low signal intensity on T2 with foci of high signal within, indicating menstrual hemorrhage into the ectopic endometrial tissues in keeping with diffuse adenomyosis.
Both ovaries are located in close proximity in the rectouterine space " kissing ovaries sign" with right luteal cyst (32 mm) and small left endometrioma (15 mm) and hydrosalpinx.
Thickening of the uterosacral ligament and torus uterinus suggestive of deep endometriosis of the posterior compartment.
Case Discussion
MRI features most consistent with diffuse uterine adenomyosis with deep endometriosis of the posterior compartment as well as a small left ovarian endometrioma.
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