Endometriosis of the Round Ligament of the Uterus

Crispi, C.P.; Souza, C. A.; Oliveira, Marco Aurélio Pinho; Dibi, Raquel Papandreus; Cardeman, Leon; Sato, Hélio; Schor, Eduardo

doi:10.1016/j.jmig.2011.09.006

Cited by 26 publications

(18 citation statements)

References 35 publications

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“…Epidemiology and clinical characteristics: Incidence of endometriosis of the round ligaments of the uterus (RLUs) is between 0.3% and 14% (1,19,20). RLUs have an intrapelvic and an extrapelvic portion where the extrapelvic one is the distal part of the ligament in the canal of Nuck (1).…”

Section: Round Ligamentmentioning

confidence: 99%

“…Patients with endometriosis involvement of the extrapelvic portion of the RLUs at the level of the canal of Nuck usually refer a painful, palpable inguinal mass, with or without menstrual variation. Symptoms of the endometriosis of the intrapelvic portion of the RLUs are nonspecific, usually referred as pain localized in the lower abdomen (19). externally to iliac vessels, and run along the pelvic sidewall leaving the abdomen via the internal ring.…”

Section: Round Ligamentmentioning

confidence: 99%

“…They normally show fibrous signal on both T1-and T2-weighted sequences. Affected ligament appears thickened, usually more than 1 cm, shortened, and irregular, with nodular aspect on T2-weighted sequences (1,19). The signal could be various, depending on the presence of stromal tissue, glandular elements, hemorrhage, inflammatory reaction, or fibrous tissue.…”

Section: Round Ligamentmentioning

confidence: 99%

“…3, 4). A mixture of these two components, namely, fibrous tissue with low signal intensity on T1-weighted imaging and small hemorrhagic foci depicted as hyperintense signal on T1-weighted imaging are the most frequent lesions (1,19,20). The detection of free fluid around the RLUs on ''antideclive position'' might be an indirect sign of endometriosis of the intrapelvic portion of the RLUs (21).…”

Section: Round Ligamentmentioning

confidence: 99%

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Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Gui¹,

Valentini²,

Ninivaggi³

et al. 2017

Diagn Interv Radiol

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Endometriosis is a systemic disease that affects about 10% to 20% of women during their reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity (1). Endometriosis lesions are characterized by intralesional recurrent bleeding during menses, because of the hormonal responsiveness of ectopic endometrial tissue, with resulting fibrosis. Typical symptoms are cyclic or chronic pelvic pain, dysmenorrhea, dyspareunia, and pain during defecation or urinating. Unusual endometriosis localizations may be associated with more specific symptoms depending on the site of the localization. According to Siegelmen et al. (2) there are three forms of pelvic endometriosis: (a) superficial peritoneal lesions; (b) ovarian endometrioma; (c) deep (or solid infiltrating) endometriosis (DIE), which is histologically identified as a lesion that extends more than 5 mm into the subperitoneal space and/or affects the wall of organs in the pelvis and ligaments. In superficial endometriosis, superficial plaques are disseminated across the peritoneum, adnexa and ligaments of the uterus; these noninvasive implants are well recognized at laparoscopy and not often detectable with magnetic resonance imaging (MRI). Laparoscopy is the standard of reference for the diagnosis of endometriosis but nodules covered by adhesions and subperitoneal disease are difficult to study. Pouch of Douglas, uterosacral ligaments, torus uterinus, and bowel are the most frequent sites of deep pelvic endometriosis localization. Atypical pelvic localizations of endometriosis can occur at level of the cervix, vagina, round ligaments, ureter, and nerves. Rare extrapelvic endometriosis implants can also be localized in the upper abdomen, subphrenic fold, or subcutaneous fat tissue of the abdominal wall. The focus of this review is to describe atypical pelvic and abdominal localizations of endometriosis that should be known by radiologists in order to correctly identify and characterize these lesions on MRI. Moreover, we describe the MRI appearance of the implants at specific sites and review the literature with special attention to imaging reports and description. 272From the Institute of Radiology, Diagnostic Area (B.G.  benedetta.gui@policlinicogemelli.it, A.L.V., V.N., M.M., V.Z., P.P.G., F.C., L.B.) and the Institute of Obstetrics and Gynecology, Female Health Area (M.G.), Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy; "F. Miulli" Regional General Hospital (M.G.), Acquaviva delle Fonti, Bari, Italy. ABSTRACTEndometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelv...

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Section: Round Ligamentmentioning

confidence: 99%

Section: Round Ligamentmentioning

confidence: 99%

Section: Round Ligamentmentioning

confidence: 99%

Section: Round Ligamentmentioning

confidence: 99%

See 2 more Smart Citations

Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Gui¹,

Valentini²,

Ninivaggi³

et al. 2017

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…Interestingly, a retrospective analysis of women undergoing laparoscopy for treatment of deep infiltrating endometriosis (DIE) demonstrated a prevalence of endometriosis of the round ligament of 13.8%. 7 They still removed the inner part of the round ligament, even for cases of macroscopic alterations; such as shortening, deviation or thickening for a histopathological analysis. In the light of this, such an endometriosis manifestation seems to be underestimated, and a rigorous evaluation of the structure must now become part of the routine surgical treatment of patients with endometriosis.…”

mentioning

confidence: 99%