Large anechogenic “Holes” in the uterus: The utility of contextual combination of ultrasound and hysteroscopy

Cystic adenomyosis is a rare occurrence, especially in young patients. We report a challenging case of a 44- year-old African patient, in which the ultrasound described a large bilobate anechogenic cyst in the myometrium. The combination of ultrasound, contextual hysteroscopy, and subsequent magnetic resonance imaging helped to clarify the case, reducing the risk of complications for the patient, potentially due to misdiagnosis.