Primary megaureter mimicking hydrosalpinx on ultrasonography

Tubular adnexal masses are common findings during pelvic sonography and engender a reasonably short and straightforward list of differential diagnoses. Prominent in this list is hydrosalpinx, the dilated fallopian tube that typically appears as a fluid-filled tubular structure, often with folds or turns.(1-3) Although the possible confusion between a hydrosalpinx and other adnexal entities, such as dilated pelvic veins, fluid-filled loops of bowel, and ovarian cysts, is well described,(1,2,4,5) the additional possibility of a dilated ureter has not, to our knowledge, been similarly emphasized. We describe the clinical and ultrasonographic findings in a patient with a primary megaureter that mimicked a hydrosalpinx on ultrasonography, and we discuss ultrasonographic features that may serve to distinguish the two conditions.