PMC4921180_01
(A-B) Axial T1- and T2-weighted images reveal bilateral solid nodular structures with homogeneous, mild hyperintensity in the anterior lower pelvic wall, adjacent to the external inguinal ring, compatible with testes (black arrow); (C) Sagittal T2 TSE image shows subtle, hyperintense, tubular structure similar to atrophic epididymides behind the gonads (black arrow).
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T2, in the inguinal canal close to the external ring, consistent with testes (Fig. 1, A-B). The right gonad measured 1.8x1.9x3.1 cm, and the left measured 1.7x2.4x2.9 cm. Tubular, subtle, T2-hyperintense structures, adjacent to the gonads, were seen; they appeared to be similar in size and shape to atrophic epididymides (Fig. 1C). There was no evidence of the uterus in the pelvis; sagittal T2W TSE demonstrated the presence of a short, blind-ended vagina between the bladder and (posteriorly) the rectum.
Sagittal T2 TSE shows a blind-ended vagina (white arrow) between the bladder and the rectum posteriorly and the absence of Mullerian structures, such as the uterus; a fluid collection fills the Douglas pouch (white arrowhead).
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In the recto-uterine pouch, there was free fluid collection (Fig. 2).
DWI demonstrates hyperintense signal of the extrapelvic gonads; ADC map shows bilateral low signal intensity with 0.8 mm2/s on the right and 0.9 mm2/s on the left. No signs of malignant degeneration are detected.
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DWI (b=1000) showed hyperintense extrapelvic gonads due to restricted diffusion, and low values on the ADC map (0.8 mm2/s on the right and 0.9 mm2/s on the left) (Fig. 3).