Abdominal wall endometriosis: thinking outside the box

Not applicable, Tissue characterisation, Hernia, Surgery, Education, Complications, Ultrasound, MR, CT, Musculoskeletal soft tissue, Genital / Reproductive system female, Abdomen, Genitourinary Authors: C. D. O. Mira1, A. Guerra2; 1Loures/PT, 2Lisboa/PT DOI: 10.26044/ecr2020/C-12436 Learning objectives To describe the common imaging findings of abdominal wall endometriosis, with focus on magnetic resonance; To review typical location of abdominal wall endometriosis lesions and their particularities; To highlight the useful findings in differential diagnosis with other entities.

Endometriosis consists in the presence of functional endometrial glands and stroma outside the uterine cavity. It affects as many as 10% of women of reproductive age and is found in 20%–50% of women with infertility and 90% of women with chronic pelvic pain. It most commonly involves the pelvis in the form of peritoneal superficial implants, deep endometriosis and endometriomas. Abdominal wall is the most frequent location of extrapelvic endometriosis, usually associated with a surgical procedure, commonlyacaesarean section. The most likely pathogenic mechanism is iatrogenic... Findings and procedure details Common Imaging Findings Abdominal wall endometriosis may be identified at differentimaging modalities, both in symptomatic as well as asymptomatic patients. Imaging findings combined with clinical history are important for the diagnosis. Ultrasound(US) is usually the first imaging examination. However, features are nonspecific and there iswide spectrum of differential diagnosis. Computer tomography (CT) may help to confirm the presence of a tissue or cystic mass in abdominal wall and defining its extent. Nevertheless, findings may also be nonspecific. Magnetic resonance imaging (MRI) is the cross-sectional modality...

MR is a valuable imaging tool in the evaluation of endometriosis, providing a roadmap to surgery and allowing depiction of abdominal wall lesions. The abdominal wall should be systematically reviewed for potentially resectable lesions. Personal information and conflict of interest C. D. O. Mira; Loures/PT - nothing to disclose A. Guerra; Lisbon/PT - nothing to disclose

1.Siegelman E, Oliver ER (2012). MR Imaging of Endometriosis: Ten Imaging Pearls. RadioGraphics; 32:1675–1691 2. Chamié LP, Blasbalg R, Pereira RMA, Warmbrand , Serafini PC (2011). Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy. RadioGraphics; 31:E77–E100 3. Machairiotis N, Stylianaki A, Dryllis G (2013). Extrapelvic endometriosis: a rare entity or an under diagnosed condition?. Diagnostic Pathology, 8:194 4. Teha J, Leunga J, Dharb S, Athanasouc NA (2004). Abdominal wall endometriosis: comparative imaging on power Doppler ultrasound and MRI. Clinical Radiology Extra 59,...