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Case Reports
. 2025 Apr 16;109(1):16.
doi: 10.5334/jbsr.3898. eCollection 2025.

Endometriosis of the Round Ligaments in Twins: A Rare and Unique Presentation

Tom Oyen  1 , Ragna Vanslembrouck  1
Affiliations
Case Reports

Endometriosis of the Round Ligaments in Twins: A Rare and Unique Presentation

Tom Oyen et al. J Belg Soc Radiol. .

Abstract

Teaching point: The role of magnetic resonance imaging (MRI) in diagnosing endometriosis is growing, requiring radiologists to become familiar with both typical and atypical presentations of deep infiltrating endometriosis.

Keywords: Nuck; endometriosis; inguinal canal; magnetic resonance imaging; mri; twin; twins.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity; T1-weighted fat suppressed image shows an isointense area in the left inguinal region; Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement
Figure 1
A. Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity. B. Axial T1‑weighted fat suppressed image shows an isointense area in the left inguinal region. C. Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement.
Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity; T1-weighted fat suppressed image shows an isointense area in the left inguinal region; Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement
Figure 1
A. Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity. B. Axial T1‑weighted fat suppressed image shows an isointense area in the left inguinal region. C. Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement.
Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity; T1-weighted fat suppressed image shows an isointense area in the left inguinal region; Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement
Figure 1
A. Ultrasound shows an mildly heterogeneous, hypoechoic mass with vascularity. B. Axial T1‑weighted fat suppressed image shows an isointense area in the left inguinal region. C. Same region as in Figure 1b, after intravenous administration of gadolinium, showing vivid lesional enhancement.
Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal; Sagittal T2-weighted image of the same area as Figure 2b; Axial T1-weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci
Figure 2
A. Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal. B. Sagittal T2‑weighted image of the same area as Figure 2b. C. Axial T1‑weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci.
Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal; Sagittal T2-weighted image of the same area as Figure 2b; Axial T1-weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci
Figure 2
A. Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal. B. Sagittal T2‑weighted image of the same area as Figure 2b. C. Axial T1‑weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci.
Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal; Sagittal T2-weighted image of the same area as Figure 2b; Axial T1-weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci
Figure 2
A. Axial T2‑weighted image shows a hypointense area in the right inguinal region with hyperintense foci. The mass is adjacent to the extrapelvic portion of the right round uterine ligament in the inguinal canal. B. Sagittal T2‑weighted image of the same area as Figure 2b. C. Axial T1‑weighted image with fat suppression shows the lesion with an isointense signal and discrete T1 hyperintense foci.
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References

    1. Gui B, Valentini AL, Ninivaggi V, et al. Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis. Diagn Interv Radiol. 2017;23(4):272–281. 10.5152/dir.2017.16364. - DOI - PMC - PubMed
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