Re: Endometrioma decidualization in pregnancy: not just about papillations

In: Ultrasound in Obstetrics & Gynecology · 2025 · vol. 66(1) , pp. 111–112 · doi:10.1002/uog.29277 · PMID:40485313 · W4411159961
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This correspondence discusses decidualization in endometriomas during pregnancy, building upon the findings of Doglioli et al. and highlighting its significance beyond simple papillations.

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This correspondence critiques a previous study by Doglioli et al. regarding the ultrasound features and clinical outcomes of endometriomas that undergo decidualization during pregnancy. The authors argue that while papillary projections are a known feature, they should not be the sole diagnostic criterion for distinguishing benign decidualized endometriomas from malignant ovarian masses in pregnant patients. The paper highlights the importance of comprehensive ultrasound evaluation using established strategies like the International Ovarian Tumor Analysis to avoid misdiagnosis and unnecessary intervention. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Linked article: This Correspondence comments on Doglioli et al. Click here to view the article.
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UniCamillus, International Medical University, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy UniCamillus, International Medical University, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy Linked article: This Correspondence comments on Doglioli et al. Click here to view the article. Linked article: Click here to see the Reply to this Correspondence. Moro, F., Mascilini, F., Fagotti, A. and Testa, A.C. (2025), Re: Endometrioma decidualization in pregnancy: not just about papillations. Ultrasound Obstet Gynecol, 66: 111-112. https://doi.org/10.1002/uog.29277 Linked article: This Correspondence comments on Doglioli et al. Click here to view the article. DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request. References 1Doglioli M, De Meis L, Mantovani E, Cristani G, Seracchioli R, Del Forno S. Endometrioma decidualization in pregnancy: not just about papillations. Ultrasound Obstet Gynecol. 2025; 65(5): 657-658. 3Vergote I, De Brabanter J, Fyles A, et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet. 2001; 357(9251): 176-182. 4Colombo N, Sessa C, du Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol. 2019; 30(5): 672-705. 6Barcroft J, Pandrich M, Del Forno S, et al. Evaluating use of two-step International Ovarian Tumor Analysis strategy to classify adnexal masses identified in pregnancy: pilot study. Ultrasound Obstet Gynecol. 2024; 64(6): 808-817. 7Mascilini F, Savelli L, Scifo MC, et al. Ovarian masses with papillary projections diagnosed and removed during pregnancy: ultrasound features and histological diagnosis. Ultrasound Obstet Gynecol. 2017; 50(1): 116-123. 8Moro F, Mascilini F, Pasciuto T, et al. Ultrasound features and clinical outcome of patients with malignant ovarian masses diagnosed during pregnancy: experience of a gynecological oncology ultrasound center. Int J Gynecol Cancer. 2019; 29(7): 1182-1194. 9Moro F, Mascilini F, Casella E, Pasciuto T, Scambia G, Testa AC. 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endometrioma

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References (9)

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