Retrocervical Mass

HISTORY: - 38 year-old lady- One year secondary infertility- Regular menstrual cycle with Dysmenorrhea (10/10), and bloating and non-cyclicpain (7/10).Pelvic Examination:- Top normal myomatous and fixed uterus, with nodular uterosacrals andrectovaginal septum.MRI:- Anteverted retroflexed uterus (83*40*45).- An oval circumscribed mass (48*45mm) in the right paracervical region withadhesion to cervix with central necrosis - which is a suspicious finding (excisionhighly suggested).- Adhesive ovaries, left ovarian endometrioma 66*45mm, involvement of therectosigmoid muscularies layer.Ultrasonography: (Pathologic findings)- Heterogeneous myomatous uterus.- With 48*39mm hypoechoic intramural myoma in the right side of the cervix whichis located exactly in superior aspect of vaginal cuff.- Low level cyst highly suggestive of endimetrioma measured 47*40 mm adheredto the left ovary.- Obliterated pouch of duglas.- A hypoechoic nodule (16mm) in favor of DIE in upper rectal wall.Surgery Procedure:By laparoscopy, we released the adhesions, and ovariolysis cystectomy was done. Also, afterbilateral ureterolysis and dissection of the pararectal spaces and rectovaginal septum, we didthe resection of the uterosacrals and retrocervical DIE. We saw a mass in the retrocervix, and,after opening the vagina, a myoma in the right aspect of the cervix could be seen. Then,because the mass was easily fragmentable, we resected the fragments of the mass from thevagina. Currently, she is in excellent conditions, and symptoms are dissolved.Pathology:Mass is leiomyoma and other is endometriosis.