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Case Report
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| Magnetic resonance imaging features of vaginal endometriosis | ||||||
| Valeria Fiaschetti1, Valentina Cama2, Laura Greco2, Maria Fornari2, Giuseppe Sorrenti3, Giovanni Simonetti4 | ||||||
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1Research, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy. University Hospital Tor Vergata, Rome, Italy.
2Resident, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy. University Hospital Tor Vergata, Rome, Italy. 3MD, Department of Gynecology and Obstetrics, University Hospital Tor Vergata, Rome, Italy. 4Professor, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy. University Hospital Tor Vergata, Rome, Italy. | ||||||
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| How to cite this article: |
| Fiaschetti V, Cama V, Greco L, Fornari M, Sorrenti G, Simonetti G. Magnetic resonance imaging features of vaginal endometriosis. International Journal of Case Reports and Images 2013;4(8):431–435. |
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Abstract
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Introduction:
Deeply infiltrating endometriosis (DIE) is defined by the presence of endometrial implants penetrating under the peritoneal surface or under the wall of the pelvic organs to a depth of at least 5 mm. This case report describes a case of DIE involving vaginal wall, periurethral tissue, torus uterinus and sigmoid wall.
Case Report: A 46-year-old female was presented with pelvic pain and deep dyspareunia which started six years ago, after a spontaneous interruption of pregnancy and uterine curettage. The pelvic magnetic resonance imaging (MRI) showed multiple DIE lesions localized in the vaginal wall mainly in the lower third of the vagina, between the anterior vaginal wall and the urethra, on the contour of the urethra and between the torus uterinus and the sigmoid wall. After MRI, laparoscopic biopsies confirmed the DIE lesions. Conclusion: According to the implantion theory, we assume that in our case the vaginal endometriosis was the result of implantation of endometrial glands into the vaginal tearing during the surgical procedure of curettage. In the current literature no author has so far described a diffuse involvement of the vaginal wall in the presence of uterine curettage after interruption of pregnancy. In our case, the anterior (peri-urethral tissue), middle (vaginal wall) and posterior (torus uterinus and bowel wall) compartments are involved. We can presume that the vaginal DIE is an early lesion, while the others lesions arise from vaginal walls by a contiguous extension. On MRI with endovaginal gel these lesions were more evident rather than without gel. MRI with gel allows us to give essential preoperative mapping for the surgical removal of the DIE lesions. | |
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Keywords:
Vaginal endometriosis, Deeply infiltrating endometriosis (DIE), Endovaginal gel
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Author Contributions
Valeria Fiaschetti – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Valentina Cama – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Laura Greco – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Maria Fornari – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Giuseppe Sorrenti – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Giovanni Simonetti – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Valeria Fiaschetti et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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