PMC3718839_01
Magnetic resonance imaging showing changes after the administration of dienogest. Upper image, in January 2009; middle image, in April 2010; lower image, in June 2011. The size of the endometriotic cyst markedly decreased from 45 mm x 40 mm before treatment to 27 mm x 20 mm in April 2010 and to 24 mm x 5 mm in June 2011.. Note: The arrows point to ovarian cysts.. Abbreviations: L, left; R, right.
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In addition, a 45 mm x 40 mm endometriotic cyst was observed on the right side using magnetic resonance imaging (Figure 1, upper image). The size of the endometriotic cyst had markedly decreased to 24 mm x 5 mm in June 2011 (Figure 1, lower image).
Changes in lower gastrointestinal endoscopic images. Upper images, taken in 2009; middle images, taken in 2010; lower images, taken in 2011.. Note: 1-3 is the area biopsy was performed.
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Figure 2 (upper images) show the endoscopic findings of the lower gastrointestinal tract. A lower gastrointestinal endoscopy that was performed in April 2010 revealed that the lesions in both the sigmoid clone and the upper part of the rectum had markedly decreased (Figure 2 , middle images). When a lower gastrointestinal endoscopy was performed again in June 2011, the endometriotic lesions were not observed endoscopically (Figure 2, lower images).
Changes in histopathological findings. Upper pictures, before treatment; lower pictures, after 22-months of treatment.
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Figure 3 (upper images) shows the histopathological findings. Therefore, we concluded that the intestinal endometriosis lesions had disappeared (Figure 3, lower images).