Nongynecologic Lesions Mimicking Gynecologic Diseases

In female patients, various nongynecologic pelvic masses may mimic gynecologic tumors and cause difficulty in diagnosis and treatment. Examples of these nongynecologic masses include various pelvic retroperitoneal tumors, bowel-related masses, and peritoneal lesions. These lesions may perplex gynecologic surgeons if they are not correctly diagnosed preoperatively. However, misdiagnosis can be avoided by careful observation of the mass per se and the pelvic anatomy related to the mass. A demonstration of both ovaries indicates that the mass is probably a nonovarian mass. Demonstration by Doppler US, CT, or MRI of the vessels supplying the mass may give a useful clue to the correct preoperative diagnosis. When prominent vessels are seen in the interface between the uterus and a juxtauterine mass, the mass is most likely a subserosal myoma. When these interface vessels are seen in the cranial aspect of the mass, it is probably not a gynecologic mass but rather a mass of bowel or mesenteric origin. Similar content being viewed by others Suggested Reading Bittle MM, Chew FS. Radiological reasoning: recurrent right lower quadrant inflammatory mass. AJR Am J Roentgenol. 2005;185:188–94. Bullard Dunn K. Retrorectal tumors. Surg Clin North Am. 2010;90:163–71. Caspi B, Cassif E, Auslender R, et al. The onion skin sign: a specific sonographic marker of appendiceal mucocele. J Ultrasound Med. 2004;23:117–21. Damani N, Wilson SR. Nongynecologic applications of transvaginal US. Radiographics. 1999;19:S179–200. Hobson KG, Ghaemmaghami V, Roe JP, et al. Tumors of the retrorectal space. Dis Colon Rectum. 2005;48:1964–74. Hoffer FA, Kozakewich H, Colodny A, et al. Peritoneal inclusion cysts: ovarian fluid in peritoneal adhesions. Radiology. 1988;169:189–91. Jain KA. Imaging of peritoneal inclusion cysts. AJR Am J Roentgenol. 2000;174:1559–63. Jeong JY, Kim SH. Sclerohterapy of peritoneal inclusion cysts: preliminary results in seven patients. Korean J Radiol. 2001;2:164–70. Kim SH. Retroperitoneal diseases. In: Kim SH, editor. Radiology illustrated: uroradiology. Philadelphia: WB Saunders; 2003a. p. 705–76. Kim SH. Urinary bladder. In: Kim SH, editor. Radiology illustrated: uroradiology. Philadelphia: WB Saunders; 2003b. p. 497–552. Kim SH. Non-gynecologic lesions mimicking gynecologic diseases. In: Kim SH, editor. Radiology illustrated: uroradiology. Philadelphia: WB Saunders; 2005. p. 899–924. Kim SH, Choi BI, Im JG, et al. Chronic pelvic paragonimiasis: radiological findings. Seoul J Med. 1994;35:289–93. Kim JS, Lee HJ, Woo SK, et al. Peritoneal inclusion cysts and their relationship to the ovaries: evaluation with sonography. Radiology. 1997;204:481–4. Kim SH, Sim JS, Seong CK. Interface vessels on color/power Doppler US and MRI: a clue to differentiate subserosal uterine myomas from extrauterine tumors. J Comput Assist Tomogr. 2001;25:36–42. Kurachi H, Murakami T, Nakamura H, et al. Imaging of peritoneal pseudocysts: value of MR imaging compared with sonography and CT. AJR Am J Roentgenol. 1993;160:589–91. Moyle H, Hines O, McFadden DW. Gossypiboma of the abdomen. Arch Surg. 1996;131:566–8. Pickhardt PJ, Levy AD, Rohrmann CA Jr, et al. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics. 2003;23:645–62. Pinto V, Ingravallo G, Cicinelli E, et al. Gastrointestinal stromal tumors mimicking gynecological masses on ultrasound: a report of two cases. Ultrasound Obstet Gynecol. 2007;30:359–61. Sahin-Akyar G, Yagci C, Aytac S. Pseudotumor due to surgical sponge: gossypiboma. Australas Radiol. 1997;41:288–91. Sohaey R, Gardner TL, Woodward PJ, et al. Sonographic diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 1995;14:913–7. Teoh WC, Teo SY, Ong CL. Gastrointestinal stromal tumors presenting as gynecological masses: usefulness of multidetector computed tomography. Ultrasound Obstet Gynecol. 2011;37:107–9. Yang DM, Jung DH, Kim H, et al. Retroperitoneal cystic masses: CT, clinical, and pathologic findings and literature review. Radiographics. 2004;24:1353–65.

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