[Differential diagnostic challenges of abdominal wall endometriosis from the radiologist's point of view]

The incidence of endometriosis, including atypical forms of the disease, has been continuously growing, thus increasingly challenging for the imaging specialists as well. We conducted a retrospective study to analyze the results of ultrasound-guided interventions between 2016 and 2018. All interventions were performed in female patients due to uncertain abdominal wall lesions at the University of Szeged, Hungary. The abdominal wall lesions were incidentally detected, one by CT, the others by ultrasound examinations. We identified 12 cases during the study period. The average age of the patients was 59 years (29-79), 8 of them had abdominal surgery in their medical history. The mean diameter of the masses was 34.4 mm (20-49 mm). Since the indication of imaging examinations was the evaluation of a known or suspected malignancy, four patients had undergone an MRI prior to the biopsy. In addition, ultrasound-guided biopsy was not performed in another two patients, and the diagnosis was established by histological examination of the surgically removed specimens. The histological examination revealed malignant primary serous epithelial tumor in one case, metastases in six cases, endometriosis in six patients and abdominal wall abscess was found in one patient. Endometriosis was more frequent in the younger patients. The likelihood of endometriosis as a cause of abdominal wall lesions of younger, premenopausal female patients is rather high, especially with obstetrical or gynaecological operations in the medical history. Ultrasound plays a primary role in the detection and therapy planning of these lesions. Orv Hetil. 2019; 160(35): 1395-1403.