Department of Radiology, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 7708503, Japan.
Department of Radiological Technology, Tokushima Bunri University, 1314-1, Shido, Sanuki City, Kagawa, Japan.
Abdom Radiol (NY). 2016 Sep;41(9):1699-702. doi: 10.1007/s00261-016-0696-9.
Polypoid endometriosis is a benign, rare variant of endometriosis which forms multiple polypoid nodules in the female pelvis mimicking malignant tumors; however, it may rarely cause malignant transformation. We report magnetic resonance imaging findings of a case of polypoid endometriosis with malignant transformation. Multiple high-signal intensity polypoid nodules in the cul-de-sac surrounded by low-signal intensity rim-like fibrous adhesion protruding to the posterior wall of the uterine body were demonstrated on T2-weighted images. The polypoid nodules showed weak contrast enhancement compared with that of uterine myometrium on post-contrast T1-weighted images, and slight high signal intensity on diffusion-weighted images with relatively high mean apparent diffusion coefficient. Reported cases of polypoid endometriosis showed intense contrast enhancement similar to that of uterine myometrium, and weak contrast enhancement similar to that of endometrial carcinoma may be suggestive for malignant transformation of polypoid endometriosis.
息肉状子宫内膜异位症是一种良性、罕见的子宫内膜异位症变异，在女性盆腔中形成多个息肉状结节，类似于恶性肿瘤；然而，它可能很少发生恶性转化。我们报告了一例息肉状子宫内膜异位症恶变的磁共振成像表现。T2 加权图像显示子宫骶骨内有多发性高信号强度的息肉状结节，周围有低信号强度的边缘状纤维粘连，向子宫体后壁突出。息肉状结节在增强后 T1 加权图像上的对比增强弱于子宫平滑肌，在弥散加权图像上呈稍高信号强度，平均表观扩散系数相对较高。报道的息肉状子宫内膜异位症病例显示出与子宫平滑肌相似的强烈对比增强，而与子宫内膜癌相似的弱对比增强可能提示息肉状子宫内膜异位症的恶性转化。
