Ultrasonography and Atypical Sites of Endometriosis

• Published in: Diagnostics (Basel) Vol. 10; no. 6; p. 345
• Main Authors: Guerriero, Stefano, Conway, Francesca, Pascual, Maria Angela, Graupera, Betlem, Ajossa, Silvia, Neri, Manuela, Musa, Eleonora, Pedrassani, Marcelo, Alcazar, Juan Luis
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 27-05-2020; MDPI AG
• Subjects: appendiceal endometriosis; endometriosis of the rectus muscle; hepatic endometriosis; inguinal endometriosis; perineal endometriosis; Review; scar endometriosis; appendiceal endometriosis; peripheral nerves endometriosis; diaphragmatic endometriosis; inguinal endometriosis; endometriosis of pancreas; endometriosis of the rectus muscle; hepatic endometriosis; scar endometriosis; endometriosis of kidney; perineal endometriosis
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics10060345

In the present pictorial we show the ultrasonographic appearances of endometriosis in atypical sites. Scar endometriosis may present as a hypoechoic solid nodule with hyperechoic spots while umbilical endometriosis may appear as solid or partially cystic areas with ill-defined margins. In the case of endometriosis of the rectus muscle, ultrasonography usually demonstrates a heterogeneous hypoechogenic formation with indistinct edges. Inguinal endometriosis is quite variable in its ultrasonographic presentation showing a completely solid mass or a mixed solid and cystic mass. The typical ultrasonographic finding associated with perineal endometriosis is the presence of a solid lesion near to the episiotomy scar. Under ultrasonography, appendiceal endometriosis is characterized by a solid lesion in the wall of the small bowel, usually well defined. Superficial hepatic endometriosis is characterized by a small hypoechoic lesion interrupting the hepatic capsula, usually hyperechoic. Ultrasound endometriosis of the pancreas is characterized by a small hypoechoic lesion while endometriosis of the kidney is characterized by a hyperechoic small nodule. Diaphragmatic endometriosis showed typically small hypoechoic lesions. Only peripheral nerves can be investigated using ultrasound, with a typical solid appearance. In conclusion, ultrasonography seems to have a fundamental role in the majority of endometriosis cases in "atypical" sites, in all the cases where "typical" clinical findings are present.