OP06.06: Sonographic apperance of endomyometriosis ‐ case report

This 43 year old women underwent laparoscopic supravaginal hysterectomy (using a morcelator) in 1998 because of abnormal bleeding and suspected myoma on ultrasound. The pathology report showed suspicion of leiomyoma and adenomyosis. The cervix was removed later the same year because of persistent postcoital bleeding, the histology showed chronic inflammation, and a endomeriotic gland in the deeper parts. The following year the women came back because of pain in the abdominal wall and a palpable tender nodule 3 × 3 × 5 cm was found. At surgery extensive endometriotic nodules was found in subcutaneous tissue and underneath the fascia, the pathology report showed endometrial focus with surrounding smooth muscle metaplasia, “endomyometriosis”. After surgery the women was given GnRH analogue for several years. In 2002 the pain increased again. At surgery endometriotic nodules was found again in the abdominal wall and on the peritoneal surfaces, in addition fibroids was found at the tip of the vagina and in the pouch of Douglass despite that that the uterus and cervix had been previously removed. The histology showed endometriosis and a focus of “endomyometriosis”. The women was then given COC continuously without withdrawal bleed. The pain increased again in 2008. At ultrasound examination bilateral multilocularsolid cysts were found. The soilid component showed rich wasculaisation and the echostructure resembled a myoma. The cystic components looked like endometriomas. At surgery endometriotic cysts was found and solid, fibroid looking tumors was again found at the tip of the vagina and in the pouch of Douglass. The pathology report showed endometriosis and “endomyometriosis”. This case present the pathological, surgical and sonographic apperance of the very rare condition endomyometriosis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.