MRI appearance of florid cystic endosalpingiosis of the uterus: a case report

Abstract

Endosalpingiosis is a non-neoplastic proliferation of ectopic tubal epithelium. It may be found incidentally or the patients may present with chronic pelvic pain. It may resemble a gynecologic malignancy on imaging findings and clinicians and radiologists should be aware of this benign entity to render a correct diagnosis and to avoid over-treatment. We report here the MR imaging appearance of a case of florid cystic endosalpingiosis.

Keywords: Endosalpingiosis; Florid cystic; Magnetic resonance (MR).

Fig. 1

Florid cystic endosalpingiosis of uterus in 40-year-old woman. A-C. Sagittal T2-weighted (A), axial T2-weighted (B) and axial post-contrast fat suppressed T1-weighted (C) images show heterogeneously enhancing complex cystic mass involving posterior myometrium at uterocervical junction and extending into pouch of Douglas. Discrete cystic lesion is seen in posterior cervical stroma and this appears as being predominantly hyperintense on T2-weighted images (arrow). D, E. Sagittal post-contrast fat suppressed T1-weighted image (D) shows no significant post-contrast enhancement in discrete cystic lesion in posterior cervical stroma (arrow). Sagittal pre-contrast T1-weighted image (E) shows small areas of hyperintensity interspersed within cystic lesion (arrow). There was no evidence of hemorrhage within lesion on pathologic examination and small areas of hyperintensity were presumed to be mucinous content. F. Resected specimen of corpus uteri and cervix shows irregular grayish white tissue adherent to posterior serosal surface. G, H. Microphotograph showing multiple foci of cystically dilated glands in posterior cervical stroma (Hematoxylin & Eosin stain × 100) (G). Microphotograph showing circular gland lined by tubal epithelium. Adjoining cystic structures also noted (H).