Broad Ligament Endometriosis Presenting as a Solid Mass: A Diagnostic “Curveball”

Neeral R. Patel, Kostas Lathouras, Roberto Dina, Alan Farthing, Victoria Stewart, Nishat Bharwani
In: Journal of Gynecologic Surgery · 2018 · vol. 34(4) , pp. 225–228 · doi:10.1089/gyn.2017.0137 · W2885310695
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This case report describes a 32-year-old premenopausal woman whose broad ligament endometriosis presented as a solid, atypical adnexal mass on MRI, requiring surgical resection and microscopic confirmation.

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Abstract

Background: Peritoneal endometriotic deposits are most commonly small nodules or plaques; however, these deposits may rarely present as large solid masses. Endometriosis associated with the broad ligament is particularly infrequent. Case: A 32-year-old premenopausal female presented to the authors' gynecology clinic with lower abdominal pain. Magnetic resonance imaging showed a large left-adnexal lesion arising from the broad ligament. The lesion was of a predominantly high T2-weighted signal, low T1-weighted signal, and contained several foci of high signal on the T1 fat-suppressed sequences consistent with a hemorrhagic component. Intraoperatively, the mass was of solid morphology. The patient underwent open resection of the left parametrial mass with conservation of the uterus as well as the fallopian tubes and ovaries bilaterally. Results: Microscopic examination of the excised broad ligament mass showed endometrial stroma within which inactive endometrial glands were present, consistent with nodular endometriosis. Conclusions: Solid endometriotic lesions can have atypical imaging and macroscopic appearances and can cause diagnostic confusion. This case serves as a reminder for multidisciplinary teams to consider this pathology in the correct clinical and radiologic context. (J GYNECOL SURG 34:225)

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Condition tags

endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (10)

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