Abdominal wall endometriomas near cesarean delivery scars: sonographic and color doppler findings in a series of 12 patients

Francica G, Giampiero Francica, Cristiano Giardiello, Giardiello C, Angelone G, Giovanni Angelone, Cristiano S, Stefano Cristiano, Finelli R, Raffaele Finelli, Tramontano G, Giampaolo Tramontano
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2003 · vol. 22(10) , pp. 1041–1047 · doi:10.7863/jum.2003.22.10.1041 · PMID:14606559 · W1917200036
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This study describes the sonographic and color Doppler features of abdominal wall endometriomas near cesarean scars, finding characteristic echotexture, margins, rings, and vascular patterns that aid preoperative diagnosis.

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Abstract

PURPOSE: To describe the sonographic and color Doppler features of endometriomas of the abdominal wall arising near cesarean delivery scars. METHODS: Twelve women (mean age, 31 years; range, 22-42 years) underwent sonographic and color Doppler examination of the abdominal wall with high-frequency probes for the presence of painful nodules near cesarean delivery scars, cyclic or continuous lower abdominal pain, or both. RESULTS: All patients had undergone at least 1 cesarean delivery before admission (mean, 4.1 years; range, 2-12 years). A typical clinical presentation (ie, mass and cyclic pain and swelling during menses) was recorded in 6 cases. Sonography disclosed all subcutaneous nodules (mean size, 28.1 mm; range, 7-50 mm). Common sonographic features included (1) a hypoechoic inhomogeneous echo texture with internal scattered hyperechoic echoes; (2) irregular margins, often spiculated, infiltrating the adjacent tissues; and (3) a hyperechoic ring of variable width and continuity. At color Doppler examination, a single vascular pedicle entering the mass at the periphery was shown in 7 cases. Abundant intralesional vascularization was shown in 3 cases with diameters of greater than 3 cm, whereas no vascular sign could be detected in 2 lesions smaller than 15 mm. All patients underwent wide surgical excision, and pathologic examination disclosed endometrial tissue in all of them. No relapses were recorded at clinical and sonographic follow-up (4-23 months). CONCLUSIONS: Sonographic and color Doppler findings, when properly combined with clinical data, may substantially contribute to the correct preoperative diagnosis of abdominal wall endometriomas.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Wall Cesarean Section Cicatrix Endometriosis Abdominal Wall Abdominal Wall Adult Adult Cesarean Section Cesarean Section Cicatrix Cicatrix Cicatrix Cicatrix Endometriosis Endometriosis Endometriosis Female Female Humans

Citation neighborhood (2-hop)

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References (27)

Cited by (50)

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