Sonography of endometriosis in infrequent sites

Park, Sung Bin; Kim, Jeong Kon; Cho, Kyoung‐Sik

doi:10.1002/jcu.20431

Cited by 29 publications

(31 citation statements)

References 45 publications

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“…On a clinical basis, the most typical finding is a palpable small mass near the cesarean section scar becoming painful with menses [3,13,14] . However, the comparative rarity of scar endometrioma may represent a major factor explaining why the correct diagnosis is frequently overlooked by both clinicians [15] and radiologists [13,16] . Moreover, endometriosis of the abdominal wall may be a diagnostic challenge since a variety of pathologic conditions (a suture granuloma, an incisional hernia, a primary or metastatic cancer) should be taken into account in the differential diagnosis [13,16] .…”

Section: Introductionmentioning

confidence: 99%

“…However, the comparative rarity of scar endometrioma may represent a major factor explaining why the correct diagnosis is frequently overlooked by both clinicians [15] and radiologists [13,16] . Moreover, endometriosis of the abdominal wall may be a diagnostic challenge since a variety of pathologic conditions (a suture granuloma, an incisional hernia, a primary or metastatic cancer) should be taken into account in the differential diagnosis [13,16] . The aim of this study was to report on a large series of scar endometriomas by highlighting the clinical and sonographic characteristics of this neglected disease.…”

Section: Introductionmentioning

confidence: 99%

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Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

Francica¹

2012

WJR

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AIM:To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features�� METHODS: Thirty women (mean age 30��6 years, range 20-42 years) with 33 scar endometriomas (mean diameter 27��1 mm, range 7-60 mm) were consecutively studied by Sonography and Color �oppler examination prior to surgery�� Pathological examination was available in all cases�� RESULTS:The most frequent (24 of 33 nodules, 74%) sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands), a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery�� On average, 1��6 cesarean sections were recorded per patient (range 1-3)�� The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo) and the median duration of symptoms before admission was 25��7 mo (range 0��5-80 mo)�� 13 patients had 13 large endometriomas (≥ 30 mm) with a mean lesion diameter of 41��3 ± 9��02 mm (range 30-60 mm)�� Seventeen women had 20 small endometriomas with a mean lesion size of 18��2 ± 5��17 mm (range 7-26 mm)�� The mean interval between the last cesarean section and admission to hospital (66��0 mo vs 39��6 mo, P < 0��01) and the mean duration of symptoms before admission (43��0 mo vs 17��4 mo, P < 0.01) were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38��4% vs 0%, P < 0��05)�� On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0��02), loss of round/ oval shape (P < 0��04) along with increased vascularity (P < 0��04)�� CONCLUSION: Endometrioma near cesarean section scar is an often neglected disease, but knowledge of its clinical and sonographic findings may prevent a delay in diagnosis that typically occurs in patients with larger (≥ 3 cm) endometriomas��

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

Francica¹

2012

WJR

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“…[1,2] Endometriosis in an abdominal scar is rare, reported incidence being 1.08% for mid-trimester abortion and 0.03-0.4% following caesarean. [3,4]. This entity is often misdiagnosed as stitch granuloma, abscess, incisional hernia, lipoma, hematoma, desmoid tumor, sarcoma, lymphoma, or primary and metastatic cancer.…”

Section: Introductionmentioning

confidence: 99%

“…This entity is often misdiagnosed as stitch granuloma, abscess, incisional hernia, lipoma, hematoma, desmoid tumor, sarcoma, lymphoma, or primary and metastatic cancer. [4]. Due to non specific symptoms and variable presentation, the diagnosis is often delayed or missed.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Scar endometriosis: report of three cases with cytohistocorroboration

Arora

Tyagi²,

Nargotra³

et al. 2017

APALM

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Endometriosis of the abdominal wall scar is rare, reported incidence being 1.08% for mid-trimester abortion and 0.03-0.4% following caesarean sections. Incisional endometriosis is a relatively rare entity and is often misdiagnosed as stitch granuloma, abscess, incisional hernia, lipoma, hematoma, desmoid tumor, sarcoma, lymphoma, or primary and metastatic cancer.We report three cases of abdominal scar endometriosis; two cases occurring in the surgical scar of previous caesarean incision and one case occurring after second trimester hysterotomy.The present study describes the physical signs and symptoms and cytological features of abdominal scar endometriosis. A high index of suspicion is needed for early diagnosis of this entity in a woman presenting with post operative abdominal lump.

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“…The diagnosis of scar endometriosis is complicated by similarities between its clinical symptoms and those of other benign or malignant diseases of the abdominal wall, such as suture granulomas, incisional hernias, and primary or metastatic cancers [9,10]. Its comparative rarity and the uncertainties encountered in its diagnosis are the main reasons scar endometriomas are so frequently misdiagnosed by both clinicians [9,10] and radiologists [11,12].…”

Section: Introductionmentioning

confidence: 99%

Delayed diagnosis is associated with changes in the clinical and ultrasound features of subcutaneous endometriosis near cesarean section scars

Francica

Scarano

2009

Journal of Ultrasound

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KEYWORDSUltrasound; Color Doppler; Endometriosis; Cesarean section.Abstract Introduction: The aim of the present study was to highlight the sonographic and clinical characteristics of large (!30 mm in diameter) scar endometriomas near Pfannenstiel incisions, assuming that large size is a marker of delayed diagnosis. Methods: We compared clinical, ultrasound (US) and color Doppler findings in 13 patients (mean age 31.3 years) with 13 large scar endometriomas (L-SEs) (mean lesion diameter 41.8 mm; range 30e60 mm) and 17 women (mean age 30.7 years) with 19 small scar endometriomas (S-SEs) (mean lesion size 18.3 mm; range 7e26 mm). Results: Compared with the S-SE group, the L-SE group had a significantly longer mean interval between the last cesarean section and hospital admission (5.5 vs. 3.3 years; p < 0.01) and longer mean duration of symptoms before admission (43 vs. 17.4 months; p < 0.01). The L-SE group also had a significantly higher percentage of patients who had undergone at least one inconclusive diagnostic examination (Computed Tomography, Magnetic Resonance Imaging, fine needle biopsy, or laparoscopy) (39% vs. 0%; p < 0.05). As for US findings, L-SEs more frequently displayed cystic regions and fistulous tracts (p < 0.05), loss of round/oval shape (p < 0.05), and increased vascularity (p < 0.05). Conclusions: Delayed diagnosis of scar endometrioma reflected by a longer and more complex medical history results in larger than usual endometriomas with peculiar US findings, which are even more likely to be misinterpreted by physicians and radiologists.Sommario Introduzione: Scopo dello studio è valutare le caratteristiche ecografiche e cliniche di endometriomi in prossimità di cicatrice di Pfannenstiel in rapporto a ritardo diagnostico segnalato da dimensioni ! 30 mm al momento della diagnosi istologica. Metodi: Sono stati confrontati i dati clinico-anamnestici, ecografici e Color Doppler di 13 pazienti (età media 31.3 anni) con 13 endometriomi ! 30 mm (Ø medio 41.8 mm; range 30e60 mm) e di 17 pazienti (età media 30.7 anni) con 19 endometriomi < 30 mm (Ø medio 18.3 mm; range 7e26). In tutti i casi era disponibile il risultato istologico su campione operatorio. Risultati: Nelle pazienti con endometrioma !30 mm risultavano più lunghi sia il tempo medio intercorso tra il ricovero e ultimo taglio cesareo (5.5 vs. 3.3 anni; p < 0.01) che la durata media * Corresponding author. UO di Ecografia Diagnostica e Interventistica, Presidio Ospedaliero Camilliani ''S. Maria della Pietà'' -Via S. Rocco 9 e 80026 Casoria (NA), Italy.E-mail address: giampierofrancica@tin.it (G. Francica). dei sintomi prima del ricovero (43 vs. 17.4 mesi; p < 0.01). Inoltre, indagini diagnostiche diverse dall'ecografia (TC, RM, FNB, celioscopia) o interventi chirurgici incongrui si registravano nel 39% delle pazienti con endometriomi ! 30 mm, ma in nessuna di quelle con piccoli noduli (p < 0.05). Dal punto di vista ecografico gli endometriomi ! 30 mm mostravano più spesso (p < 0.05) perdita della morfologia ovalare, aree liquide interne, tra...

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Sonography of endometriosis in infrequent sites

Cited by 29 publications

References 45 publications

Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

Abdominal Scar endometriosis: report of three cases with cytohistocorroboration

Delayed diagnosis is associated with changes in the clinical and ultrasound features of subcutaneous endometriosis near cesarean section scars

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