Polypoid endometriosis of the Douglas pouch

Adrien Jacquot, A Jacquot, Witold Gertych, W Gertych, F Golfier, François Golfier, M Devouassoux-Shisheboran, Mojgan Devouassoux‐Shisheboran, Pascal Rousset, P Rousset
Radiology case reports · 2020 · vol. 16(3) , pp. 612–614 · doi:10.1016/j.radcr.2020.12.054 · PMID:33456638 · W3118085158
article OA: gold CC0 ⤵ 10 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 43-year-old female whose polypoid endometriosis of the Douglas pouch was diagnosed via MRI, leading to surgical resection and symptom relief.

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Abstract

Polypoid endometriosis is a rare form of endometriosis that corresponds to a benign variant but which systematically mimics malignant tumors. Magnetic resonance imaging (MRI) is the preferred imaging modality for these lesions. We present herein a case of a 43-year-old female with recent pelvic pain and longstanding dyspareunia related to polypoid endometriosis of the Douglas pouch. MRI found an infiltrative lesion 6 cm in diameter with intermediate signal on T2-weighted imaging, cystic hemorrhagic spots, and fibrous surrounding rim of nodular portion. There was no functional sign of malignancy (no diffusion restriction, pronounced tumor enhancement, or metastasis). The patient underwent total abdominal radical colpohysterectomy with bilateral salpingectomy and ovarian transposition was performed. Histopathological examination found a multinodular endometrial-type polypoid mass arising from the serosa of the cervix, with cystic area and fibrous surrounding tissue. In the case presented, MRI findings were useful for preoperative diagnosis that altered patient management by supporting a complete but reasonable surgical resection that yielded relief of symptoms.

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endometriosisdyspareunia

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