OBGY Radiology

Case 6 :

A 32-year-old female with right pelvic pain. A transvaginal ultrasound performed in the gynecologist’s clinic revealed a lobulated cystic lesion in the pelvis, suggestive of a right ovarian cyst. Laparoscopy showed no cystic mass lesion, with normal ovaries and uterus. CT scan of pelvis was performed. 
What is the diagnosis?
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Imaging Findings

 Study shows a lobulated low attenuation lesion seen in the pelvis, sections were extended beyond the pelvis, and this cystic “mass” was seen extending into the upper moiety of right kidney. A “cobra-head” appearance of ureterocele was seen in the urinary bladder on the right. Lower moiety of right kidney showed normal function. No ovarian mass was detected.


Congenital megaloureter with ureterocele in a duplex right kidney.


 The term megaloureter is usually reserved for cases of congenital dilatation of the ureter when there is no organic obstruction or vesico-ureteric reflux. In some patients, the bladder capacity may be markedly distended (megaloureter-megacystis syndrome). No organic obstruction is usually demonstrable, and a ureteric catheter can be passed usually without any great difficulty.

Cause of this condition is not known but it has been suggested that the functional obstruction at the uretero-vesical junction is the result of abnormal arrangement of the circular fibers of the ureteric musculature. Stasis in a megaloureter may predispose to infection or stone formation.


 Dr. Nikhil Cunha, Mumbai