Fig. 2

Ovarian endometrioid adenocarcinoma within an endometrioma in a 39-year-old woman with a known history of endometriosis. Sagittal T2-weighted image (a) shows a left ovarian cystic mass (asterisk) without a T2-shading effect. Axial T2-weighted image (b) shows a mural nodule (arrow) with restricted diffusion on a high b800 value image and corresponding ADC map (c). The axial fat-suppressed T1-weighted image (d) displays a typical right ovarian endometrioma (arrowheads). Axial contrast-enhanced fat-suppressed T1-weighted image (e) shows a light enhancement of the nodule, better displayed on the subtraction sequence (f). Dynamic contrast enhancement analysis of the nodular portion (g, h) demonstrates a type 3 curve (blue curve, located above normal myometrium in the yellow curve), consistent with a malignant etiology