title: Complex abdominopelvic endometriosis: the radiologist's perspective.
abstract: Endometriosis is a multifocal gynecological disorder affecting approximately 6%-10% of women during their reproductive years (Giudice and Kao in: Lancet 364:1789-1799, 2004). Presenting symptomatology often relates to the anatomical structures involved. Given the complexity of both the management and pain control of patients with complex endometriosis, the British Society of Gynaecological Endoscopy has issued guidelines on the establishment of a multidisciplinary team approach to these cases (http://www.bsge.org.uk/ec-requirements-BSGE-accredited-endometriosis-centre.php). The ovaries are the most common site affected, but the gastrointestinal, genitourinary tract, chest and other soft tissues are not infrequently involved. Less well-recognized features of the disease include the deep infiltrative form of endometriosis, malignant transformation and decidualization of endometriomas under progesterone. In this pictorial essay, we will discuss the clinical presentation and review the imaging features of these complex and under appreciated forms of endometriotic disease.
authors: University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester, Greater Manchester, M23 9LT, United Kingdom. tanzilah@gmail.com.
authors: Tanzilah Afzal
authors: TA
authors: Barrow
authors: University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester, Greater Manchester, M23 9LT, United Kingdom.
authors: Marwa
authors: M
authors: Elsayed
authors: University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester, Greater Manchester, M23 9LT, United Kingdom.
authors: Sue Yin
authors: SY
authors: Liong
authors: University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester, Greater Manchester, M23 9LT, United Kingdom. sathi.sukumar@uhsm.nhs.uk.
authors: Sathi Anandan
authors: SA
authors: Sukumar
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014551:Urinary Tract / Q000000981:diagnostic imaging / Q000473:pathology; D014567:Urography; D014570:Urologic Diseases / Q000175:diagnosis*
keywords: Decidualization; Deep infiltrative endometriosis; Endometrioma; Malignant transformation; Solid fibrotic endometriosis