45-year-old female patient with history of fibroid uterus. PELVIS:UTERUS, ADNEXA: Bulky, fibroid uterus measures up to 10.2 cm in long axis. Largest fibroid along the left fundus measures 3.9 x 4.1 cm in axial dimension (series 501 image 39). The majority of the fibroids are intralumenal and the larger fibroids enhance heterogenously. The junctional zone is within normal limits for age.There is a cyst in the left adnexa with dependent decreased T2 signal and homogeneous T1 hyperintense signal that measures 4.6 x 2.7 cm (series 501 image 31). There is an additional cyst that measures 2.2 x 2.2 cm (series 501 image 36) with decreased T2 signal in the dependent portion of the cyst and homogeneous T1 hyperintense signal. Both cysts have thin walls without internal enhancement.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis.
1.Bulky fibroid uterus.2.Two cysts in the left adnexa suspicious for endometriomas given signal characteristics including apparent T2 shading and presuming that one of the lesions visualized correlates to the 2.9 cm lesion reported on prior pelvic sonography and so suggesting that lesion persists after several weeks (favoring an endometrioma over a hemorrhagic cyst, the latter would be expected to demonstrate interval involution). Lesions may be followed up with pelvic ultrasound to differentiate from hemorrhagic cysts.