Abdominal wall endometriosis with round ligament connection
Updates to Case Attributes
Endometriosis is characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Extrapelvic endometriosis in a rare occurrence and cases have been reported of endometriosis of the gastrointestinal tract, urinary tract, upper and lower respiratory system, diaphragm, pleura and the pericardium, as well as abdominal scars loci.
Anterior abdominal wall endometriosis (AAWE) is an even more rare ocurrence, specially if there is no history of previous gynaecologic interventions, as this patient's case.
It's still largely unknown the mechanism of the pathogenesis of AAWE and this case is further more unclear, since there was no described external endometrium cells spreading mechanism to the anterior abdominal wall.
In the present study the referred lesion is clearly localised suprapubic right to the midline, anterior and adjacent to the rectus abdominis muscle, with a not very clear cleavage plane. It is also visible, mostly in the transverse plane, a filiform structure "connecting" the endometriumuterus to the lesion in the anterior abdominal wall. Both findings have the same signal intensity behaviour throughout the different sequences. This filiform structure has the potential of representing a pathway for the endometrium cells to reach the abdominal wall.
The diagnostic of AAWE was later confirmed by fine needle aspiration cytology results, which demonstrated the presence of endometrium cells in the anterior abdominal wall lesion. Unfortunately this procedure was not feasible for the filiform lesion.
-<p>Endometriosis is characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Extrapelvic endometriosis in a rare occurrence and cases have been reported of endometriosis of the gastrointestinal tract, urinary tract, upper and lower respiratory system, diaphragm, pleura and the pericardium, as well as abdominal scars loci.</p><p>Anterior abdominal wall endometriosis (AAWE) is an even more rare ocurrence, specially if there is no history of previous gynaecologic interventions, as this patient's case.</p><p>It's still largely unknown the mechanism of the pathogenesis of AAWE and this case is further more unclear, since there was no described external endometrium cells spreading mechanism to the anterior abdominal wall.</p><p>In the present study the referred lesion is clearly localised suprapubic right to the midline, anterior and adjacent to the rectus abdominis muscle, with a not very clear cleavage plane. It is also visible, mostly in the transverse plane, a filiform structure "connecting" the endometrium to the lesion in the anterior abdominal wall. Both findings have the same signal intensity behaviour throughout the different sequences. This filiform structure has the potential of representing a pathway for the endometrium cells to reach the abdominal wall.</p><p>The diagnostic of AAWE was later confirmed by fine needle aspiration cytology results, which demonstrated the presence of endometrium cells in the anterior abdominal wall lesion. Unfortunately this procedure was not feasible for the filiform lesion.</p>- +<p>Endometriosis is characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Extrapelvic endometriosis in a rare occurrence and cases have been reported of endometriosis of the gastrointestinal tract, urinary tract, upper and lower respiratory system, diaphragm, pleura and the pericardium, as well as abdominal scars loci.</p><p>Anterior abdominal wall endometriosis (AAWE) is an even more rare ocurrence, specially if there is no history of previous gynaecologic interventions, as this patient's case.</p><p>It's still largely unknown the mechanism of the pathogenesis of AAWE and this case is further more unclear, since there was no described external endometrium cells spreading mechanism to the anterior abdominal wall.</p><p>In the present study the referred lesion is clearly localised suprapubic right to the midline, anterior and adjacent to the rectus abdominis muscle, with a not very clear cleavage plane. It is also visible, mostly in the transverse plane, a filiform structure "connecting" the uterus to the lesion in the anterior abdominal wall. Both findings have the same signal intensity behaviour throughout the different sequences. This filiform structure has the potential of representing a pathway for the endometrium cells to reach the abdominal wall.</p><p>The diagnostic of AAWE was later confirmed by fine needle aspiration cytology results, which demonstrated the presence of endometrium cells in the anterior abdominal wall lesion. Unfortunately this procedure was not feasible for the filiform lesion.</p>