45 Solid Pelvic Masses

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GU 45-1 Uterine fibroids. Sagittal sonogram of the uterus (U) shows multiple hypoechoic masses (m) within the uterus. The dilated endometrial cavity (E) contains low-level echoes representing blood.27

• Fig GU 45-2 Calcified uterine fibroid. Sagittal sonogram of the uterus (U) shows a small calcified focus (arrow) and acoustic shadowing due to a degenerated leiomyoma. (B, bladder.)27

• Fig GU 45-3 Leiomyosarcoma. Sagittal sonogram of the uterus (U) shows a complex mass in the region of the cervix (arrow) and a hypoechoic lesion in the uterine fundus (arrowhead). (O, ovary.)27

Fig GU 45-4 Leiomyosarcoma. Sagittal sonogram shows a grossly distorted uterus (U) with hypoechoic areas throughout it.27

• Fig GU 45-5 Endometrial carcinoma. Longitudinal sonogram shows the uterus to be enlarged and bulbous. There are clusters of high-amplitude echoes (arrows) in the region of the central cavity echo. (Bl, bladder.)43

Fig GU 45-6 Carcinoma of the cervix. Solid, echogenic retrovesical mass (*) that is indistinguishable from a cervical myoma. (Bl, bladder; H, head.)43

Fig GU 45-7 Dysgerminoma. Transverse sonogram demonstrates a predominantly solid mass in the right adnexa (arrow). (O, ovary; U, uterus.)27

• Fig GU 45-8 Endodermal sinus tumor. Longitudinal scan in a 9-year-old girl shows a large pelvic mass (arrows) that extended to the level of the umbilicus. This diagnosis should always be considered in a young patient with abdominal pain and an abdominopelvic mass.58

• Fig GU 45-9 Krukenberg's tumor. Sagittal scan shows a lobulated mass containing both cystic and solid (arrowheads) components that represented a metastasis to the ovary from carcinoma of the gastrointestinal tract.27

• Fig GU 45-10 Trophoblastic disease. Real-time image of the uterus reveals a soft-tissue mass with multiple cystic areas of varying sizes (arrowheads).27

• Fig GU 45-11 Trophoblastic disease. Sagittal sonogram shows a uterine mass (M) containing irregular cystic areas (arrowheads) representing degeneration or internal hemorrhage in the molar tissue. (B, bladder.)27