Endometriosis of Abdominal and Pelvic Wall Scars: Multimodality Imaging Findings, Pathologic Correlation, and Radiologic Mimics

Rita Gidwaney, Gidwaney R, Badler RL, Ruth L. Badler, Benjamin L. Yam, Yam BL, J. Hines, Hines JJ, John J Hines, Alexeeva V, Vlada Alexeeva, Virginia Donovan, Donovan V, Katz DS, Douglas S. Katz
Radiographics : a review publication of the Radiological Society of North America, Inc · 2012 · vol. 32(7) , pp. 2031–2043 · doi:10.1148/rg.327125024 · PMID:23150856 · W2168474057
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This paper describes the imaging features of endometriosis occurring in abdominal and pelvic wall scars, differentiating it from potential mimics and correlating findings with pathology.

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Abstract

Implantation of an endometriotic lesion within a pelvic or abdominal wall scar is an uncommon but well-described condition that may be the underlying cause of acute or chronic recurrent abdominal or pelvic pain, especially after cesarean section. Radiologists may not consider scar endometriosis when it is encountered at cross-sectional imaging. Cesarean section scars are the most common site of extraovarian or extrauterine endometriosis. The condition also has been identified in other uterine surgery-related scars and in the skin, subcutaneous tissues, and abdominal and pelvic wall musculature adjacent to these scars. The most plausible cause of scar endometriosis is implantation of endometrial stem cells at the surgical site at the time of uterine surgery. Patients with scar endometriosis may be asymptomatic or present with cyclical pain corresponding to the menstrual cycle. Cross-sectional imaging findings vary from the nonspecific to those suggestive of the diagnosis when combined with clinical history. In particular, the presence of blood products in an anterior abdominal wall mass at magnetic resonance (MR) imaging with no other explanation is strongly suggestive of scar endometriosis. Ultrasonography, computed tomography, and MR imaging may be used to depict an endometriotic lesion, exclude endometriosis, or provide evidence for an alternative diagnosis.

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Condition tags

endometriosis

MeSH descriptors

Cicatrix Cicatrix Endometriosis Endometriosis Pelvic Inflammatory Disease Radiography, Abdominal Adult Cicatrix Endometriosis Female Humans Middle Aged Pelvic Inflammatory Disease Pelvic Inflammatory Disease Radiography, Abdominal Tomography, X-Ray Computed Tomography, X-Ray Computed

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (38)

Cited by (50)

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