Fig. 1

Endometrioid adenocarcinoma within a right ovarian endometrioma in a 43-year-old woman without any medical history. Axial T2-weighted image (a) shows a large ovarian cystic mass with chronic bleeding (asterisk) displaying a “T2-shading” appearance and peripheral wall nodules (arrows). The axial T1-weighted (b) and fat-suppressed T1-weighted (c) images confirm the hemorrhagic cystic content. Enhancement of the nodules is seen on fat-suppressed T1-weighted following gadolinium chelates injection (d). The axial diffusion image (e) shows the high signal intensity regarding neoplastic nodules, with corresponding low intensity on the ADC map (f). Sagittal T2-weighted image (g) shows features of pelvic endometriosis with uterine adenomyoma (arrowheads) and several hemorrhagic foci (arrowhead) with anterior rectal wall involvement (dotted arrow) on axial fat-suppressed T1-weighted image (h)