Ovarian Endometriosis

Ovarian endometriosis is a common form of endometriosis. Typically, on ultrasound, it appears as a cystic lesion with “ground-glass” echogenicity with no papillary projection or solid areas. This cystic lesion is also known as an ovarian endometrioma or “chocolate cyst” due to the cyst’s content. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Redwine DB. Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril. 1999;72:310–5. Sokalska A, Timmerman D, Testa AC, Van Holsbeke C, Lissoni AA, Leone FP, Jurkovic D, Valentin L. Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses. Ultrasound Obstet Gynecol. 2009;34:462–70. Alcázar JL, Guerriero S, Laparte C, Ajossa S, Ruiz-Zambrana A, Melis GB. Diagnostic performance of transvaginal gray-scale ultrasound for specific diagnosis of benign ovarian cysts in relation to menopausal status. Maturitas. 2011;68:182–8. Al-Fozan H, Tulandi T. Left lateral predisposition of endometriosis and endometrioma. Obstet Gynecol. 2003;101:164–6. Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68:585–96. Chapron C, Pietin-Vialle C, Borghese B, Davy C, Foulot H, Chopin N. Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis. Fertil Steril. 2009;92:453–7. Nishida M, Watanabe K, Sato N, Ichikawa Y. Malignant transformation of ovarian endometriosis. Gynecol Obstet Investig. 2000;50(Suppl 1):18–25. Alcázar JL, Olartecoechea B, Guerriero S, Jurado M. Expectant management of adnexal masses in selected premenopausal women: a prospective observational study. Ultrasound Obstet Gynecol. 2013;41:582–8. Garcia-Tejedor A, Fernandez-Montoli ME, Pla Farnos MJ, Ponce Sebastia J. Management of ovarian endometrioma. In: Fernandez-Montoli ME, Gine Martinez L, Ponce Sebastia J, editors. Endometriosis. A multidisciplinary approach. New York: Nova Biomedical; 2013. p. 135–54. Guerriero S, Ajossa S, Gerada M, Virgilio B, Pilloni M, Galvan R, Laparte C, Alcazar JL, Melis GB. Transvaginal ultrasonography in the diagnosis of extrauterine pelvic disease. Expert Rev Obstet Gynecol. 2008;3:731–52. Sayasneh A, Ekechi C, Ferrara L, Kaijser J, Stalder C, Sur S, Timmerman D, Bourne T. The characteristic ultrasound features of specific types of ovarian pathology. Int J Oncol. 2015;46:445–58. Kupfer MC, Schwimer SR, Lebovic J. Transvaginal sonographic appearance of endometriomata: spectrum of findings. J Ultrasound Med. 1992;11:129–33. Van Holsbeke C, Van Calster B, Guerriero S, Savelli L, Paladini D, Lissoni AA, Czekierdowski A, Fischerova D, Zhang J, Mestdagh G, Testa AC, Bourne T, Valentin L, Timmerman D. Endometriomas: their ultrasound characteristics. Ultrasound Obstet Gynecol. 2010;35:730–40. Pascual MA, Tresserra F, López-Marín L, Ubeda A, Grases PJ, Dexeus S. Role of color Doppler ultrasonography in the diagnosis of endometriotic cyst. J Ultrasound Med. 2000;19:695–9. Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA. Endometriomas: diagnostic performance of US. Radiology. 1999;210:739–45. Brown DL, Frates MC, Muto MG, Welch WR. Small echogenic foci in the ovaries: correlation with histologic findings. J Ultrasound Med. 2004;23:307–13. Clarke L, Edwards A, Pollard K. Acoustic streaming in ovarian cysts. J Ultrasound Med. 2005;24:617–21. Van Holsbeke C, Zhang J, Van Belle V, Paladini D, Guerriero S, Czekierdowski A, Muggah H, Ombelet W, Jurkovic D, Testa AC, Valentin L, Van Huffel S, Bourne T, Timmerman D. Acoustic streaming cannot discriminate reliably between endometriomas and other types of adnexal lesion: a multicenter study of 633 adnexal masses. Ultrasound Obstet Gynecol. 2010;35:349–53. Guerriero S, Ajossa S, Garau N, Alcazar JL, Mais V, Melis GB. Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography. Fertil Steril. 2010;94:742–6. Guerriero S, Ajossa S, Gerada M, Virgilio B, Angioni S, Melis GB. Diagnostic value of transvaginal ‘tenderness-guided’ ultrasonography for the prediction of location of deep endometriosis. Hum Reprod. 2008;23:2452–7. Guerriero S, Van Calster B, Somigliana E, Ajossa S, Froyman W, De Cock B, Coosemans A, Fischerová D, Van Holsbeke C, Alcazar JL, Testa AC, Valentin L, Bourne T, Timmerman D. Age-related differences in the sonographic characteristics of endometriomas. Hum Reprod. 2016;31:1723–31. Mascilini F, Moruzzi C, Giansiracusa C, Guastafierro F, Savelli L, De Meis L, Epstein E, Timor-Tritsch IE, Mailath-Pokorny M, Ercoli A, Exacoustos C, Benacerraf BR, Valentin L, Testa AC. Imaging in gynecological disease. 10: Clinical and ultrasound characteristics of decidualized endometriomas surgically removed during pregnancy. Ultrasound Obstet Gynecol. 2014;44:354–60. Groszmann Y, Howitt BE, Bromley B, Feltmate CM, Benacerraf BR. Decidualized endometrioma masquerading as ovarian cancer in pregnancy. J Ultrasound Med. 2014;33:1909–15. Guerriero S, Ajossa S, Piras S, Parodo G, Melis GB. Serial ultrasonographic evaluation of a decidualized endometrioma in pregnancy. Ultrasound Obstet Gynecol. 2005;26:304–6. Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer. 2014;110:1878–90. Testa AC, Timmerman D, Van Holsbeke C, Zannoni GF, Fransis S, Moerman P, Vellone V, Mascilini F, Licameli A, Ludovisi M, Di Legge A, Scambia G, Ferrandina G. Ovarian cancer arising in endometrioid cysts: ultrasound findings. Ultrasound Obstet Gynecol. 2011;38:99–106. Moore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol. 2002;20:630–4. Guerriero S, Alcazar JL, Pascual MA, Ajossa S, Gerada M, Bargellini R, Virgilio B, Melis GB. Diagnosis of the most frequent benign ovarian cysts: is ultrasonography accurate and reproducible? J Womens Health (Larchmt). 2009;18:519–27. Alcázar JL, Laparte C, Jurado M, López-García G. The role of transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler in the diagnosis of endometrioma. Fertil Steril. 1997;67:487–91. Guerriero S, Ajossa S, Mais V, Risalvato A, Lai MP, Melis GB. The diagnosis of endometriomas using colour Doppler energy imaging. Hum Reprod. 1998;13:1691–5. Alcázar JL. Transvaginal colour Doppler in patients with ovarian endometriomas and pelvic pain. Hum Reprod. 2001;16:2672–5. Alcázar JL, García-Manero M. Ovarian endometrioma vascularization in women with pelvic pain. Fertil Steril. 2007;87(6):1271. Seckin B, Oruc AS, Turkcapar F, Ugur M. The relation of pelvic pain and dense adhesions to Doppler ultrasound findings in patients with ovarian endometriomas. Arch Gynecol Obstet. 2013;287:723–8. Alcázar JL, León M, Galván R, Guerriero S. Assessment of cyst content using mean gray value for discriminating endometrioma from other unilocular cysts in premenopausal women. Ultrasound Obstet Gynecol. 2010;35:228–32. Huang CY, Wang HI, Wang PH, Wu YC, Yang MJ, Chen LH, Chao KC, Chen CY. Mean grey value is lower in endometriomas: differentiating a hypoechogenic adnexal cyst by 3-dimensional power Doppler ultrasound--a preliminary study. J Chin Med Assoc. 2011;74:75–80. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations 5.1 Electronic Supplementary Material In this video, acoustic streaming in a case of ovarian endometrioma can be observed. Note the movement of the cyst’s particles (AVI 9349 kb) (AVI 9349 kb) In this case, the adhesion of the ovary to the uterus is clearly noted when moving the transvaginal probe back and forth (MP4 1342 kb) (MP4 1342 kb) In this case, the ovarian endometrioma is not attached to the uterus, and we can observe the sliding of the cyst against the cervix (MP4 965 kb) (MP4 965 kb) This video corresponds to a case of endometrioma decidualization during pregnancy. A highly vascularized cystic solid mass can be seen. The cyst was surgically removed, and histologic analysis proved it was a decidualized endometrioma (MP4 4081 kb) (MP4 4081 kb) Rights and permissions Copyright information © 2018 Springer International Publishing AG, part of Springer Nature About this chapter Cite this chapter Alcázar, J.L. (2018). Ovarian Endometriosis. In: Guerriero, S., Condous, G., Alcázar, J.L. (eds) How to Perform Ultrasonography in Endometriosis. Springer, Cham. https://doi.org/10.1007/978-3-319-71138-6_5 Download citation DOI: https://doi.org/10.1007/978-3-319-71138-6_5 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-71137-9 Online ISBN: 978-3-319-71138-6 eBook Packages: MedicineMedicine (R0)