• To demonstrate the MR imaging features of solid appearing components in endometriomas
• To discuss the pitfalls in decision of benign and malignant when endometrioma presents with solid appearing components.

Endometriosis is a common disease entity affecting about 10% of reproductive-age women. It has a wide variety of symptoms and clinical consequences ranging from benign lesions to malignant transformation. Although the traditional diagnosis of pelvic endometriosis is established by laparoscopy or exploratory surgery, MR imaging has been widely used in accurate diagnosis of endometriomas and demonstrate the extent of the disease.

Endometriosis is associated with significantly increased risk of clear-cell, endometrioid and low-grade serous ovarian cancers. An estimated 2.5% of women with endometriosis develop ovarian cancer. Patients with an endometrioma-related ovarian cancer generally present at a younger age (10–20 years younger than patients with other subtypes of epithelial ovarian cancer), with an earlier stage and lower grade of disease, and hence have a...

...read more

MR imaging serves as an excellent modality for accurate diagnosis of endometriomas, demonstration of extent of the disease and malignant transformation in endometriomas. Solid appearing components in endometriomas may cause diagnostic challenges since benign solid components may rarely mimic malignancy. Recognition of the spectrum of MR features of endometriomas with solid components is beneficial for safely distinction of malignant from benign lesions, and thus prompt management of those patients.