Variations in appearance of endometriomas
Elizabeth Asch1, Deborah Levine
1Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Summary
Endometriomas, often presenting with varied appearances due to patient age and lesion characteristics, can be challenging to diagnose preoperatively. Recognizing these diverse sonographic findings is crucial for accurate diagnosis.
Area of Science:
- Reproductive Medicine
- Diagnostic Imaging
- Gynecologic Pathology
Background:
- Endometriomas exhibit variable sonographic appearances due to patient age, lesion persistence, and internal blood product degradation.
- Accurate preoperative diagnosis of endometriomas is essential for appropriate patient management.
Purpose of the Study:
- To identify prospective diagnoses for surgically confirmed endometriomas.
- To illustrate the diverse sonographic appearances of endometriomas.
Main Methods:
- Retrospective review of sonographic images from 325 women with histologically confirmed adnexal masses.
- Analysis of prospective diagnoses for 87 endometriomas in 71 women.
- Inclusion of lesions with classic and atypical endometrioma appearances for illustration.
Main Results:
- Endometrioma was included in the differential diagnosis for 60.3% of endometriomas ≥2 cm.
- 10.3% of endometriomas were misdiagnosed as complex or hemorrhagic cysts.
- Atypical presentations included retracted clots, pregnant patients, postmenopausal changes, and ruptured endometriomas mimicking other conditions.
Conclusions:
- The varied sonographic appearance of endometriomas necessitates awareness among interpreting physicians.
- Improved recognition of diverse endometrioma presentations can enhance diagnostic accuracy.
- This study aids in distinguishing endometriomas from other adnexal masses.
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