Abstract
Many atypical locations for deep endometriosis exist that are not well known to both the radiologist and gynecologist. This work explores these unusual localizations, which we have arbitrarily grouped under the term “anterior endometriosis” in contrast to the more common posterior presentation of deep endometriosis that has been so well described in the literature. Parietal and inguinal involvement is first detailed, followed by a description of deep endometriosis involving the urinary system and anterior supporting ligaments of the uterus. A necessary adaptation to the MRI protocol in order to accurately diagnosis deep anterior endometriosis as well as specific diagnostic criteria for each type of lesion is reviewed.
Similar content being viewed by others
References
Jarlot C, Anglade E, Paillocher N, et al. (2008) MR imaging features of deep pelvic endometriosis: correlation with laparoscopy. J Radiol 89(11 Pt 1):1745–1754
Imaoka I, Wada A, Matsuo M, et al. (2003) MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics 23(6):1401–1421
Bazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232(2):379–389
Woodward PJ, Sohaey R, Mezzetti TP Jr (2001) Endometriosis: radiologic-pathologic correlation. Radiographics 21(1):193–216
Kinkel K, Frei KA, Balleyguier C, Chapron C (2006) Diagnosis of endometriosis with imaging: a review. Eur Radiol 16(2):285–298
Ha HK, Lim YT, Kim HS, et al. (1994) Diagnosis of pelvic endometriosis: fat-suppressed T1-weighted vs conventional MR images. AJR Am J Roentgenol 163(1):127–131
Hassanin-Negila A, Cardini S, Ladam-Marcus V, et al. (2006) Endometriomas of the abdominal wall: imaging findings. J Radiol 87(11 Pt 1):1691–1695
Hensen JH, Van Breda Vriesman AC, Puylaert JB (2006) Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol 186(3):616–620
Zhao X, Lang J, Leng J, et al. (2005) Abdominal wall endometriomas. Int J Gynaecol Obstet 90(3):218–222
Kaunitz A, Di Sant’Agnese PA (1979) Needle tract endometriosis: an unusual complication of amniocentesis. Obstet Gynecol 54(6):753–755
Thylan S (1995) Cutaneous and subcutaneous endometriosis. Dermatol Surg 21(8):737
Gunes M, Kayikcioglu F, Ozturkoglu E, Haberal A (2005) Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet Gynaecol Res 31(5):471–475
Teng CC, Yang HM, Chen KF, et al. (2008) Abdominal wall endometriosis: an overlooked but possibly preventable complication. Taiwan J Obstet Gynecol 47(1):42–48
Ideyi SC, Schein M, Niazi M, Gerst PH (2003) Spontaneous endometriosis of the abdominal wall. Dig Surg 20(3):246–248
Crespo R, Puig F, Marquina I (2005) Pyramidalis muscle endometriosis in absence of previous surgery. Int J Gynaecol Obstet 89(2):148–149
Blanco RG, Parithivel VS, Shah AK, et al. (2003) Abdominal wall endometriomas. Am J Surg 185(6):596–598
Toullalan O, Baqué P, Benchimol D, et al. (2000) Endometriosis of the rectus abdominis muscles. Ann Chir 125(9):880–883
Le Tohic A, Chis C, Yazbeck C, et al. (2009) Bladder endometriosis: diagnosis and treatment. A series of 24 patients. Gynecol Obstet Fertil 37(3):216–221
Comiter CV (2002) Endometriosis of the urinary tract. Urol Clin North Am 29(3):625–635
Frachet O, Mallick S, Comoz F, Rousselot P, Bensadoun H (2006) Ureteral obstruction from endometriosis: a case report and review of the literature. J Gynecol Obstet Biol Reprod 35(5 Pt 1):500–503
Antonelli A, Simeone C, Zani D, et al. (2006) Clinical aspects and surgical treatment of urinary tract endometriosis: our experience with 31 cases. Eur Urol 49(6):1093–1097
Marcelli F, Collinet P, Vinatier D, et al. (2006) Ureteric and bladder involvement of deep pelvic endometriosis. Value of multidisciplinary surgical management. Prog Urol 16(5):588–593
Fedele L, Bianchi S, Zanconato G, et al. (2005) Long-term follow-up after conservative surgery for bladder endometriosis. Fertil Steril 83(6):1729–1733
Vercellini P, Frontino G, Pisacreta A, et al. (2002) The pathogenesis of bladder detrusor endometriosis. Am J Obstet Gynecol 187(3):538–542
Balleyguier C, Chapron C, Dubuisson JB, et al. (2002) Comparison of magnetic resonance imaging and transvaginal ultrasonography in diagnosing bladder endometriosis. J Am Assoc Gynecol Laparosc 9(1):15–23
Chapron C, Boucher E, Fauconnier A, et al. (2002) Anatomopathological lesions of bladder endometriosis are heterogeneous. Fertil Steril 78(4):740–742
Acker O, Robert Y, Carpentier F, Vinatier D, Cosson M (2003) Symptomatic bladder or ureteral endometriosis: report of 8 cases and review of the literature. Ann Chir 128(1):34–39
Esen T, Akinci M, Ander H, et al. (1990) Bilateral ureteric obstruction secondary to endometriosis. Br J Urol 66(1):98–99
Miller MA, Morgan RJ (1990) Bilateral ureteric obstruction due to endometriosis resulting in unilateral loss of renal function. Br J Urol 65(4):421
Balleyguier C, Roupret M, Nguyen T, et al. (2004) Ureteral endometriosis: the role of magnetic resonance imaging. J Am Assoc Gynecol Laparosc 11(4):530–536
Strasser EJ, Davis RM (1977) Extraperitoneal inguinal endometriosis. Am Surg 43(6):421–422
Clausen I, Nielsen KT (1987) Endometriosis in the groin. Int J Gynaecol Obstet 25(6):469–471
Mashfiqul MA, Tan YM, Chintana CW (2007) Endometriosis of the inguinal canal mimicking a hernia. Singapore Med J 48(6):57–59
Licheri S, Pisano G, Erdas E, et al. (2005) Endometriosis of the round ligament: description of a clinical case and review of the literature. Hernia 9(3):294–297
Hagiwara Y, Hatori M, Moriya T, et al. (2007) Inguinal endometriosis attaching to the round ligament. Australas Radiol 51(1):91–94
Kirkpatrick A, Reed CM, Bui-Mansfield LT, Russell MJ, Whitford W (2006) Radiologic-pathologic conference of Brooke Army Medical Center: endometriosis of the canal of Nuck. AJR Am J Roentgenol 186(1):56–57
Cervini P, Mahoney J, Wu L (2005) Endometriosis in the canal of Nuck: atypical manifestations in an unusual location. AJR Am J Roentgenol 185(1):284–285
Turpin F, Daclin PY, Karam R, et al. (2001) A case of muscular and canal of nuck involvement by endometriosis. J Radiol 82(8):933–935
Irvin W, Pelkey T, Rice L, Andersen W (1998) Endometrial stromal sarcoma of the vulva arising in extraovarian endometriosis: a case report and literature review. Gynecol Oncol 71(2):313–316
Mesko JD, Gates H, McDonald TW, Youmans R, Lewis J (1988) Clear cell (“mesonephroid”) adenocarcinoma of the vulva arising in endometriosis: a case report. Gynecol Oncol 29(3):385–391
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Novellas, S., Chassang, M., Bouaziz, J. et al. Anterior pelvic endometriosis: MRI features. Abdom Imaging 35, 742–749 (2010). https://doi.org/10.1007/s00261-010-9600-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-010-9600-1