malignant mimicker: Endometriosis presenting as a large solid–cystic pelvic mass with lymphadenopathy and distal ureteral invasion

Payia Chadbunchachai, Kulyada Eurboonyanun, Wichien Sirithanaphol, Pochchara Watcharadetwittaya, Sasithorn Watcharadetwittaya
In: The ASEAN Journal of Radiology · 2026 · vol. 27(2) , pp. 122–138 · doi:10.46475/asean-jr.v27i2.926 · W7162493762
article OA: diamond CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This case report describes endometriosis mimicking malignancy with a large pelvic mass, lymphadenopathy, and ureteral invasion, leading to suspicion of a malignant process.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper reports a rare case of endometriosis with atypical symptoms and radiographic findings that mimicked malignancy. A patient presented with hematuria, and evaluation showed a large solid–cystic pelvic mass with skip lesions extending to the distal ureter, along with a focal lesion in the right external iliac region resembling nodal metastasis and evidence of distal ureteral invasion. The authors emphasize that endometriosis can be indistinguishable from cancer in certain imaging contexts, with an explicit limitation that this is a single case report. This paper is centrally about endometriosis — it describes endometriosis presenting as a malignant-appearing pelvic mass with lymphadenopathy and distal ureteral invasion.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Endometriosis presents with various imaging features. The most common site of endometriosis is the ovary, followed by the pelvic peritoneum. Less frequently affected sites include the deep subperitoneal tissues, the gastrointestinal tract, the urinary bladder, the thorax, and subcutaneous tissues. We present a rare case of endometriosis with atypical symptoms and radiographic features. The patient initially presented with hematuria. Evaluation revealed a pelvic mass with skip lesions extending to the distal ureter, mimicking malignancy. Focal endometriosis in the right external iliac region resembled nodal metastasis. These findings led clinicians and radiologists to suspect a malignant process. Consequently, endometriosis should be considered in the differential diagnosis under specific circumstances.
Full text 2,970 characters · extracted from oa-doi-fallback · click to expand
A malignant mimicker: Endometriosis presenting as a large solid–cystic pelvic mass with lymphadenopathy and distal ureteral invasion DOI: https://doi.org/10.46475/asean-jr.v27i2.926Keywords: Endometriosis, Endometrioma, Carcinoma, Hematuria, Ureteritis, Ureteric invasionAbstract Endometriosis presents with various imaging features. The most common site of endometriosis is the ovary, followed by the pelvic peritoneum. Less frequently affected sites include the deep subperitoneal tissues, the gastrointestinal tract, the urinary bladder, the thorax, and subcutaneous tissues. We present a rare case of endometriosis with atypical symptoms and radiographic features. The patient initially presented with hematuria. Evaluation revealed a pelvic mass with skip lesions extending to the distal ureter, mimicking malignancy. Focal endometriosis in the right external iliac region resembled nodal metastasis. These findings led clinicians and radiologists to suspect a malignant process. Consequently, endometriosis should be considered in the differential diagnosis under specific circumstances. Downloads Metrics References Takeuchi M, Matsuzaki K, Harada M. Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy. Jpn J Radiol 2024;42:801–19. doi: 10.1007/s11604-024-01569-5. DOI: https://doi.org/10.1007/s11604-024-01569-5 VanBuren W, Feldman M, Shenoy-Bhangle AS, Sakala MD, Young S, Chamie LP, et al. Radiology state-of-the-art review: Endometriosis imaging interpretation and reporting. Radiology 2024 ;312:e233482. doi: 10.1148/radiol.233482. DOI: https://doi.org/10.1148/radiol.233482 Leonardi M, Espada M, Kho RM, Magrina JF, Millischer AE, Savelli L, et al. Endometriosis and the urinary tract: From diagnosis to surgical treatment. Diagnostics (Basel) 2020 ;10:771. doi: 10.3390/diagnostics10100771. DOI: https://doi.org/10.3390/diagnostics10100771 Rennan L, Yao S, Jin H, Yi Q, Wang Y, Yang Y. Ureteral endometriosis: MR imaging appearance for predicting complex procedures. Heliyon 2024;10:e34884. doi: 10.1016/j.heliyon.2024.e34884. DOI: https://doi.org/10.1016/j.heliyon.2024.e34884 Chin S, Kitzing YX, Quesada J, Lo G. Endometriosis MRI : Atypical cases, pitfalls and mimics. J Med Imaging Radiat Oncol 2024;68:427–33. doi: 10.1111/1754-9485.13670. DOI: https://doi.org/10.1111/1754-9485.13670 Kido A, Himoto Y, Moribata Y, Kurata Y, Nakamoto Y. MRI in the diagnosis of endometriosis and related diseases. Korean J Radiol 2022;23:426-45. doi: 10.3348/kjr.2021.0405. DOI: https://doi.org/10.3348/kjr.2021.0405 Downloads Published How to Cite Issue Section License Copyright (c) 2026 The ASEAN Journal of Radiology This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Disclosure Forms and Copyright Agreements All authors listed on the manuscript must complete both the electronic copyright agreement. (in the case of acceptance)

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (4)

References (6)

Source provenance

openalex
last seen: 2026-08-25T06:02:57.817192+00:00
License: CC0 · commercial use OK