Extrapelvic Endometriosis

“Extrapelvic endometriosis” is a misleading term used in medical literature in several specialties, making it difficult and challenging to analyze comparative data and contributing to a confused understanding of the multiple forms of endometriosis. This inaccuracy has led to guidelines describing different management based on scarce evidence for recommendations (1). The occurrence of lesions in extrapelvic locations in patients diagnosed with pelvic endometriosis is estimated at 5%–10% (2) and they may be underdiagnosed (3), making a correct understanding even more difficult. Lesions can occur in various anatomical regions, and sometimes mimic several other conditions such as appendicitis (4), gastrointestinal disorders (5), orthopedic problems (6), and thoracic (7, 8), dermatologic (9), neurological, and psychiatric diseases (10). Surgical management of extrapelvic endometriosis requires a site-specific approach for each anatomical region affected, with each of their particularities and associated physiopathological knowledge and characteristics of each patient considered. They are often evaluated by different medical specialties, resulting in differing points of view and approaches and, therefore, contributing to scarce evidence-based recommendations.