{"paper_id":"21309d46-fcb3-41cc-a8ff-b9122fc96e2f","body_text":"Abstract\nA 36-year-old woman, 12 weeks pregnant, was previously diagnosed with an ovarian chocolate cyst. A transvaginal ultrasound scan detected a solid tissue component and an enhanced area within the cyst, raising suspicions of ovarian cancer. The standard protocol for confirmed ovarian cancer is to terminate the pregnancy and perform extensive ovarian cancer surgery. Conversely, if it is a case of decidualization of the ovarian chocolate cyst, monitoring without surgery is advised. An unanswered question persists: How can MRI discern between the two conditions?\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nRay JG, et al. Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA. 2016;316:952–61.\nPoder L, et al. Decidualized endometrioma during pregnancy: recognizing an imaging mimic of ovarian malignancy. J Comput Assist Tomogr. 2008;32:555–8.\nSammour RN, et al. Decidualization of ovarian endometriosis during pregnancy mimicking malignancy. J Ultrasound Med. 2005;24:1289–94.\nMiyakoshi K, et al. Decidualized ovarian endometriosis mimicking malignancy. AJR Am J Roentgenol. 1998;171:1625–6.\nTakeuchi M, et al. Magnetic resonance manifestations of decidualized endometriomas during pregnancy. J Comput Assist Tomogr. 2008;32:353–5.\nMorisawa N, et al. Magnetic resonance imaging manifestations of decidualized endometriotic cysts: comparative study with ovarian cancers associated with endometriotic cysts. J Comput Assist Tomogr. 2014;38:879–84.\nTakewa M, et al. Uterine myoma and endometrioid cyst. Jpn J Imaging Diagn. 2012;32:435–44. Japanese.\nTanaka YO, et al. A decidualized endometrial cyst in a pregnant woman: a case observed with a steady-state free precession imaging sequence. Magn Reason Imaging. 2002;20:301–4.\nTanaka YO, et al. MRI of endometriotic cysts in association with ovarian carcinoma. AJR Am J Roentgenol. 2010;194:355–61.\nTanaka Y. Endometriosis and related diseases 4 complications. In: Diagnostic imaging in obstetrics and gynecology. 1st ed. Tokyo: Kanahara Shuppan. p. 580–92. Japanese.\nKurata Y, et al. Diagnostic performance of MR imaging findings and quantitative values in the differentiation of seromucinous borderline tumor from endometriosis-related malignant ovarian tumor. Eur Radiol. 2017;27:1695–703.\nTsuno A, et al. Decidualization attenuates the contractility of eutopic and ectopic endometrial stromal cells: implications for hormone therapy of endometriosis. J Clin Endocrinol Metab. 2009;94:2516–23.\nShuri E, et al. A case of chocolate cyst desquamation with malignant transformation during Dienogest use. Okinawa Obstet Gynecol. 2011;33:96–100. Japanese.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.\nAbout this chapter\nCite this chapter\nTakewa, M. (2025). Imaging Diagnosis of Decidualized Endometriotic Cysts. In: Matsumura, N., Matsuki, M., Kido, A. (eds) MRI and CT for Decision-Making in Obstetrics and Gynecology Practice. Springer, Singapore. https://doi.org/10.1007/978-981-97-5120-4_38\nDownload citation\nDOI: https://doi.org/10.1007/978-981-97-5120-4_38\nPublished:\nPublisher Name: Springer, Singapore\nPrint ISBN: 978-981-97-5119-8\nOnline ISBN: 978-981-97-5120-4\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}