Fig. 12

Malignant evolution of an ovarian endometrioma in a 37-year-old woman. Sagittal (a) and axial (b) T2 images and axial fat-suppressed T1 images (c, d) show the pelvic endometriosis with torus uterinum thickening (dotted arrows) and typical bilateral endometriomas (arrowheads). A simple clinical surveillance was decided. MRI scan (axial and sagittal T2 images (e, f) and axial fat-suppressed T1 images before and after injection of gadolinium chelates (g, h)) performed 6 years later due to a palpable abdominal mass showed a large ovarian mixed lesion with a cystic component (asterisk) and endocystic tumoral nodules (black arrow in f). Surgery was performed and found a left ovarian borderline seromucinous carcinoma developed on endometrioma