Gastric-type adenocarcinoma of the uterine cervix is an aggressive, human papillomavirus-independent subtype carrying poor prognosis, with greater propensity for metastases, and resistance to chemotherapy and radiotherapy. Distinctive MRI features of intratumoral cysts, upper endocervical location with endophytic growth, and heterogeneous enhancement which can aid in identification of GAS and differentiation from cervical squamous cell carcinoma and other benign cervical multicystic lesions. Targeted and adequate biopsy on suspicious solid areas identified on MRI is crucial for early definitive histological diagnosis. High soft-tissue resolution of MRI and the use of dedicated double-oblique imaging planes allows accurate local tumour staging. Diffusion-weighted imaging and enhancement pattern make MRI indispensable in differentiating between post-irradiation fibrosis and recurrent tumour on post-treatment follow-up.

1. Working group SIRM-SIAARTI-SNR-AINR coordinator Tamburrini O. I mezzi di contrasto in diagnostica per immagini, raccomandazioni all’uso, reazioni avverse e trattamento, Omicron Editrice Genova. 2. R Ruiz-Cruces 1, F Ruiz, M Pérez-Martínez, J López, I Tort Ausina, A D de los Ríos; Patient dose from barium procedures, Br J Radiol . 2000 Jul;73(871):752-61. doi: 10.1259/bjr.73.871.11089468. 3. Disantis DJ, Lewis JI, Menias CO, Balfe DM, Morgan DE, Cernigliaro JG. Imaging tips for performing a perfect barium swallow. Radiographics. 2019 Sep-Oct;39(5):1325-6. 4. A. L. F. Yasin, O. Aljaziri, A. H. M. Sha'ban, A. Yousaf, F. S. R. Ameerudeen Moulana, M. A. H. Shah; A radiologist’s guide to the role of urethrography in the assessment of urethral diseases in adult males, DOI 10.26044/ecr2021/C-10954 https://epos.myesr.org/poster/esr/ecr2021/C-10954/findingsandproceduredetails 5. Catalá V et al: CT findings in urinary diversion after radical cystectomy: postsurgical anatomy and complications. Radiographics. 29(2):461-76, 2009 6. Hysterosalpingography: a reemerging study. Simpson WL Jr, Beitia LG, Mester J. Radiographics. 2006 Mar-Apr;26(2):419-31. 7. Chalazonitis, A., Tzovara, I., Laspas, F., Porfyridis, P., Ptohis, N., & Tsimitselis, G. (2009). Hysterosalpingography: technique and applications. Current Problems in Diagnostic Radiology, 38(5), 199–205. https://doi.org/10.1067/j.cpradiol.2008.02.003

The identification of the origin and nature of gynecological pelvic masses can be challenging. The most common origin of lesions of the upper female reproductive tract lesions is the ovaries. Radiological clues to identify an ovarian origin are the Phantom Ovary Sign, the Ovarian Vascular Pedicle Sign, the Beak Sign, the Ovarian Crescent Sign, and the Posterior Displacement of extraperitoneal structures. In cases where an ovarian origin is ruled out, attention is directed to consider a fallopian tube origin. The characteristic morphological signs are the Cogwheel Sign, the Waist Sign, and the "C" or "S" shaped configuration. Furthermore, the possibility of a uterine origin can be suspected by the Claw Sign and the Bridging Vessel Sign. There are also pelvic gynecological masses with origin in the broad ligament, vagina, and cervix. Concluding, radiological features, along with clinical information, aid in narrowing the differential diagnosis.

Gynecological surgery is not free from complications and their correct diagnosis is essential for patient management.Compartmentalization of the pelvic anatomy can assist the radiologist in identifying the correct post surgical complications.

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The mesonephric duct, also known as Wolffian duct (WD), is a paired organ that during embryonic development forms as a part of urogenital system draining the primitive kidney (mesonephros) into the cloaca and giving off lateral branch forming the ureteric bud. In both male and female, WD develops into urinary bladder trigone and ureters.  In male, it has a fundamental role in reproductive organ’s formation (epididymis, ejaculatory duct, vas deferens, and seminal vesicle). In female, WDs degenerate, although inclusions cyst (e.g., Gardner’s cyst) or remnant may persist.     It is well known that WD anomalies are usually diagnosed in paediatric patient, but Radiologists can encounter these anomalies also in adult population. Due to close relationship between urinary and reproductive system development, congenital malformation (especially renal agenesia / malformation) is often associated to each other.  The aim of our work is to review embryology, anatomy and pathologies related to WD through a multi modal approach (Ultrasound US, Computed Tomography CT and Magnetic Resonance imaging MRI) to make Radiologists more familiar of such conditions and their associations and to guarantee a correct diagnosis not only in paediatric patients but also in the adult population. 

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