Fig. 11

Treatment of an endometriosis-associated clear-cell carcinoma on abdominal wall caesarian scar in a 47-year-old woman. Abdominal wall ultrasound scan (a) shows an ill-defined mass containing cystic portions within the rectus abdominis muscle and subcutaneous fat (solid arrows). Further exploration by MRI with axial T2-weighted image (b) shows a mixed lesion high signal intensity on diffusion image (c high b value) and enhancement of the septae on axial contrast-enhanced fat-suppressed T1-weighted (d). The patient benefited from a complete surgical excision and pathology showed a clear cell carcinoma developed on underlying endometrioma. Two years later, local recurrence is shown on the axial T2 image and fat-suppressed enhanced T1 image (dotted arrows in e and f). Multidisciplinary decision was a conservative percutaneous cryotherapy treatment. The CT scan (g) shows the cryoprobe placement and ice formation during treatment (arrowheads). Follow-up MRI scan at 3 months (h axial fat-suppressed enhanced subtraction image) shows complete disappearance of the mass