Korean J Radiol.  2013 Dec;14(6):918-922. 10.3348/kjr.2013.14.6.918.

MR Imaging Findings of Extraovarian Endocervical Mucinous Borderline Tumors Arising from Pelvic Endometriosis

• Yeo DM
• Rha SE
• Byun JY
• Lee A
• Kim MR

• KMID: 1711458
• DOI: http://doi.org/10.3348/kjr.2013.14.6.918

Abstract

We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.

Keyword

Endocervical; Mullerian; Endometriosis; Mucinous borderline tumor

MeSH Terms

Adult
Cystadenoma, Mucinous/*diagnosis/etiology
Diagnosis, Differential
Endometriosis/complications/*diagnosis
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging/*methods
Ovarian Neoplasms/*diagnosis/etiology
Pelvis
Precancerous Conditions/*diagnosis/etiology

Figure

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  Fig. 1 Thirty five-year-old woman with extraovarian endocervical mucinous borderline tumor arising from pelvic endometriosis. Consecutive axial T2-weighted (A, B), fat-suppressed T1-weighted (C, D) and contrast-enhanced fat-suppressed T1-weighted (E, F) MR images. MR images show elongated tubular cystic lesion (asterisk in A, C) with high signal intensity on both T1- and T2-weighted images in left adnexa, which is diagnosed as hematosalpinx. Axial T2-weighted image (B) shows stellate low signal intensity lesion (arrow in B) with obliteration of cul-de-sac, suggestive of deep infiltrating endometriosis. Uterus is diffusely enlarged with focal adenomyosis and intramural myoma in posterior wall. Two small cystic lesions (arrowheads in A, D) with high signal intensity on T2-weighted image and slightly high signal intensity on T1-weighted image are present in cul-de-sac along posterior margin of uterus. Following contrast-infusion, peripheral nodular enhancement is noted in cystic lesions (arrowheads in E, F), raising possibility of malignancy. Histopathologic findings of cul-de-sac masses show multiple mucin-filled cysts (asterisks in G) and papillary projections (arrows in G) lined by endocervical type mucinous cells. These masses were confirmed as endocervical mucinous borderline tumors. Gradual transition from epitheliums of endometriosis (white arrow in H) to mucinous tumor cells (black arrow in H) was identified.

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