{"paper_id":"b4cc05c4-44fd-46f5-9462-e206c61aafbe","body_text":"Abstract\nIntroduction\nMany pathological causes are responsible for the sonographic presentation of myometrium cysts and cyst-like lesions, where the distinction between these etiologies is required.\nThe aim of the work\nThe current work is aimed at discerning between different etiologies of myometrium cysts and cyst-like lesions for an optimum management.\nMethodology\nIn the course of daily practice of gynecological transvaginal ultrasound, 66 cases of myometrium cysts and cyst-like lesions have been discerned, where all were examined with endovaginal ultrasound using a multifrequency endocavitary probe having color Doppler capability.\nResults\nAdenomyosis uteri detected in 15 cases, invasive mole in 4 cases, congested arcuate veins in 20 cases, incidental cysts in 4 cases, cystic degeneration of myoma in 3 cases, C-section scar cysts and cyst-like lesions in 13 cases, interstitial ectopic pregnancy in 2 cases, incomplete abortion with congested myometrium vessels in 4 cases, and arteriovenous malformation in 1 case. The number of cases with cervical nabothian cysts was not considered since they were too frequent.\nConclusion\nEndosonography is an important tool in differentiating between the various diseases that are responsible for benign myometrium cysts and cyst-like lesions, which are all important since some of them are visualized as serious clinical situations and others turn out to be of little clinical significance.\nRiassunto\nIntroduzione\nMolte patologie sono responsabili della presentazione ecografica di cisti del miometrio e di lesioni simil-cistiche ed è necessaria la distinzione tra le varie eziologie.\nScopo del lavoro\nScopo del lavoro è distinguere tra le diverse eziologie delle cisti del miometrio e delle lesioni simil-cistiche per una loro gestione ottimale.\nMateriali e metodi\nDurante la pratica quotidiana di ecografia transvaginale ginecologica sono stati riscontrati 66 casi di cisti del miometrio e di lesioni simil-cistiche, tutti sono stati esaminati con ecografia endovaginale con sonda endocavitaria multifrequenza e modulo Doppler.\nRisultati\nIn 15 casi è stata rilevata adenomiosi dell’utero, in 4 casi mola invasiva, in 20 casi congestione venosa, in 4 casi riscontro incidentale di cisti, in 3 casi degenerazione cistica dei miomi, in 13 casi cicatrice cistica (CS) e lesioni simil-cistiche, in 2 casi gravidanza ectopica, in 4 casi aborto incompleto con vasi del miometrio congestionati e in 1 caso malformazioni artero-venose. I casi di cisti Naboth non sono stati considerati in quanto di troppo frequente riscontro.\nConclusioni\nL’ecoendoscopia è uno strumento importante nella differenziazione delle varie malattie che sono responsabili della formazione di cisti benigne del miometrio come di lesioni simil-cistiche, alcune gravi, altre di scarsa rilevanza clinica.\nSimilar content being viewed by others\nReferences\nAtri M, Reinhold C (2000) Mehio AR et al. Adenomyosis: US features with histologic correlation in an in vitro study. Radiology 215(3):783–790\nReinhold C, Tafazoli F, Mehio A et al. (1999) Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics;19 Spec No : S147–60\nSakhel K, Abuhamad A (2012) Sonography of adenomyosis. J Ultrasound Med 31(5):805–808\nJain N, Goel S (2012) Cystic Adenomyoma simulates uterine malformation: A diagnostic dilemma: Case report of two unusual cases. J Hum Reprod Sci 5:285–288\nTamai K, Koyama T, Umeoka S, Saga T, Fujii S, Togashi K (2006) Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:583–602\nKataoka M, Togashi K et al (1998) MRI of adenomyotic cyst of uterus. J Comput Assist Tomogr 22:555–559\nSakai Y, Matsukuma S (2003) Large cystic uterine adenomyoma showing marked epithelial metaplasia and exophytic polypoidgrowth. Arch Gynecol Obstet 269(1):74–76\nJauniaux Mr E (1998) Ultrasound diagnosis and follow-up of gestational trophoblastic disease. Ultrasound Obstet Gynecol 11(5):367–377\nKaushik C, Prasad A, Singh Y, Baruah BP (2008) Case series: cystic degeneration in uterine leiomyomas. Indian J Radiol Imaging 18(1):69–72\nJurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ (2003) First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Caesarian section scar. Ultrasound Obstet Gynecol 21:220–227\nCheng P-J, Chueh H-Y, Soong Y-K (2003) Sonographic diagnosis of a uterine defect in a pregnancy at 6 weeks gestation with a history of curettage. Ultrasound Obstet Gynecol 21:501–503\nFylstra DL (2002) Ectopic pregnancy within a Caesarian scar: a review. Obstet Gynecol Surv 57:537–543\nArmstrong V, Hansen WF, Van Voorhis BJ, Syrop CH (2003) Detection of Caesarian scars by transvaginal ultrasound. Obstet Gynecol 101:61–65\nGoel P, Sood SS, Dalal A, Romilla (2005) Cesarean scar endometriosis: Report of two cases. Indian J Med Sci;59:495–8\nLahiri AK, Sharma K, Busiri N (2008) Endometriosis of the uterine cesarean section scar: A case report. Indian J Radiol Imag 18(1):66–68\nRastogi R, Meena GL, Rastogi N, Rastogi V (2008) Interstitial ectopic pregnancy: a rare and difficult clinicosonographic diagnosis. J Hum Reprod Sci. 1(2):81–82\nGrivell R, Reid K, Mellor A (2005) Uterine arteriovenous malformations: a review of the current literature. Obstet Gynaecol Survey 60(11):761–767\nPolat P, Suma S, Kantarcy M, Alper F, Levent A (2002) Colour doppler ultrasound in the evaluation of uterine vascular abnormalities. Radiographics 22:47–53\nM Nori, J Venkateswarlu (2013) Pseudoaneurysm of the uterine artery presenting as a cystic sol in fundus: diagnosis and non surgical management. Internet J Radiol. vol 16 Number 1\nNogales FF, Isaac MA, Hardisson D, Bosincu L, Palacios J, Ordi J et al (2002) Adenomatoid tumors of the uterus: an analysis of 60 cases. Inter JGynecol Pathol 21:34–40\nHendrickson MR, Tavassoli FA, Kempson RL, et al. (2003) Mesenchymal tumours and related lesions. In: Tavassoli FA, Devilee P, editors. Tumours of the breast and female genital organs. Lyon: IARC Press-World Health Organization Classification of Tumours; pp 243-4\nFurui T, Imai A, Yokoyama Y, Sato E, Tamaya T (2003) Cavernous lymphangioma arising from uterine corpus. Gynecol Oncol 90(1):195–199\nBazot M, Cortez A, Darai E, Rouger J, Chopier J et al (2001) Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 16(11):2427–2433\nTakahashi K, Okada S, Okada M, Kitao M, Kaji Y, Sugimura K (1996) Magnetic resonance relaxation time in evaluating the cyst fluid characteristics of endometrioma. Hum Reprod 11(4):857–860\nTamai K, Koyama T, Togashi K (2007) MR features of ectopic pregnancy. Eur Radiol 17(12):3236–3246\nFilhastre M, Dechaud H, Lesnik A, Taourel P (2005) Interstitial pregnancy: role of MRI. Eur Radiol 15(1):93–95\nWeinreb JC, Barkoff ND, Megibow A et al (1993) The value of MRI imaging in distinguishing leiomyomas from other solid masses when sonography is indetermine. AJR 154:295–299\nConflict of interest\nThe author declares that he has no conflict of interest.\nInformed consent\nAll patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nYoussef, A.T. Endosonography of benign myometrium cysts and cyst-like lesions. J Ultrasound 18, 213–222 (2015). https://doi.org/10.1007/s40477-014-0142-1\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s40477-014-0142-1","source_license":"CC0","license_restricted":false}