Learning objectives
To be aware that pelvic masses which may be diagnosed as gynaecological origin on initial presentation may actually arise outside pelvis and will need detailed multimodality investigation to accurately identify their aetiology.
Background
We have encountered a wide range of pathology which presented initially as a pelvic mass at initial imaging with ultrasound or MRI of the pelvis.
However these needed further assessments with other modalities (CT,
MR,
Ultrasound,
SPECT/CT,
PET/CT where appropriate) and careful elicitation of previous history and comparison with previous studies to assertain the real origin.
Findings and procedure details
Many extrapelvic pathologies can mimic or cause pelvic masses [1-7].
We have described a variety of these cases including mucocoel of the appendix,
wandering spleen,
Gastric GIST,
Indiana pouch for urinary diversion,
krukenberg's tumour,
hydroureter,
retroperitoneal fibrosis,
etc which at initial presentation were confused asgynaecological origin.
Case 1
• 72 year old female with previous hysterectomy presented with right iliac fossa (RIF) pain.
US demonstrated a large irregular vascular solid mass in theright adnexa(Figure 1) highly suspicious for an ovarian malignancy.
Normal right ovary could...
Conclusion
It is important to be aware that many pelvic masses can actually originate outside the pelvis and masquerade as gynaecological cancer at initial presentation.
Careful examination of current and previous imaging and assessment of history is very important as also is knowledge of appropriate further imaging to arrive at a definitive diagnosis to ensure that the patient gets the correct treatment.
Personal information
Dr Ranjana Dwarkanath
Consultant Radiologist
Countess of Chester hospital
CH21UL
References
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Appendix mucocele mimicking a complex ovarian cyst.
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Primary megaureter mimicking hydrosalpinx on ultrasonography.
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The characteristic ultrasound features of specific types of...
