Abdominal wall endometriomas near cesarean delivery scars: sonographic and color doppler findings in a series of 12 patients.
OBJECTIVE
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.
Francica
Giampiero
G
Servizio di Ecografia ed Ecointerventistica, Presidio Sanitario Camilliani S. Maria della Pietà, Casoria, Italy. giampierofrancica@tin.it
Giardiello
Cristiano
C
Angelone
Giovanni
G
Cristiano
Stefano
S
Finelli
Raffaele
R
Tramontano
Giampaolo
G
D034861:Abdominal Wall / Q000000981:diagnostic imaging*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color