Cystic ovarian mass resulting from repeated hemorrhage of endometrial tissue implants in response to hormonal stimulation
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Hindman N et al: Imaging spectrum of endometriosis (endometriomas to deep infiltrative endometriosis). Radiol Clin North Am. 58(2):275-89, 2020
Moro F et al: Ultrasound imaging in endometriosis. Obstet Gynecol Clin North Am. 46(4):643-59, 2019
Exacoustos C et al: Isolated ovarian endometrioma: a history between myth and reality. J Minim Invasive Gynecol. 25(5):884-91, 2018
Van den Bosch T et al: Ultrasound diagnosis of endometriosis and adenomyosis: state of the art. Best Pract Res Clin Obstet Gynaecol. 51:16-24, 2018
Corwin MT et al: Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology. 271(1):126-32, 2014
Chaudhry S et al: Detection and differential diagnosis of suspected malignant transformation of an endometrioma during pregnancy. BMJ Case Rep. 2013:bcr2012007744, 2013
Khashper A et al: T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 32(4):1047-64, 2012
McDermott S et al: MR imaging of malignancies arising in endometriomas and extraovarian endometriosis. Radiographics. 32(3):845-63, 2012
Siegelman ES et al: MR imaging of endometriosis: ten imaging pearls. Radiographics. 32(6):1675-91, 2012
Lee YR: CT imaging findings of ruptured ovarian endometriotic cysts: emphasis on the differential diagnosis with ruptured ovarian functional cysts. Korean J Radiol. 12(1):59-65, 2011
Tsili AC et al: Malignant transformation of an endometriotic cyst: MDCT and MR findings. J Radiol Case Rep. 5(1):9-17, 2011
Bennett GL et al: Unusual manifestations and complications of endometriosis--spectrum of imaging findings: pictorial review. AJR Am J Roentgenol. 194(6 Suppl):WS34-46, 2010
Dujardin M et al: Cystic lesions of the female reproductive system: a review. JBR-BTR. 93(2):56-61, 2010
Tanaka YO et al: MRI of endometriotic cysts in association with ovarian carcinoma. AJR Am J Roentgenol. 194(2):355-61, 2010
Takeuchi M et al: Susceptibility-weighted MRI of endometrioma: preliminary results. AJR Am J Roentgenol. 191(5):1366-70, 2008
Asch E et al: Variations in appearance of endometriomas. J Ultrasound Med. 26(8):993-1002, 2007
Kinkel K et al: Diagnosis of endometriosis with imaging: a review. Eur Radiol. 16(2):285-98, 2006
Lee SI: Radiological reasoning: imaging characterization of bilateral adnexal masses. AJR Am J Roentgenol. 187(3 Suppl):S460-6, 2006
Fruscella E et al: Sonographic features of decidualized ovarian endometriosis suspicious for malignancy. Ultrasound Obstet Gynecol. 24(5):578-80, 2004
Wu TT et al: Magnetic resonance imaging of ovarian cancer arising in endometriomas. J Comput Assist Tomogr. 28(6):836-8, 2004
Sala EJ et al: Magnetic resonance imaging of benign adnexal disease. Top Magn Reson Imaging. 14(4):305-27, 2003
Zanardi R et al: Staging of pelvic endometriosis based on MRI findings versus laparoscopic classification according to the American Fertility Society. Abdom Imaging. 28(5):733-42, 2003
Glastonbury CM: The shading sign. Radiology. 224(1):199-201, 2002
Modesitt SC et al: Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol. 100(4):788-95, 2002
Alcazar JL: Transvaginal colour Doppler in patients with ovarian endometriomas and pelvic pain. Hum Reprod. 16(12):2672-5, 2001
Patel MD et al: Endometriomas: diagnostic performance of US. Radiology. 210(3):739-45, 1999
Guerriero S et al: Tumor markers and transvaginal ultrasonography in the diagnosis of endometrioma. Obstet Gynecol. 88(3):403-7, 1996
Ha HK et al: Diagnosis of pelvic endometriosis: fat-suppressed T1-weighted vs conventional MR images. AJR Am J Roentgenol. 163(1):127-31, 1994
Outwater E et al: Characterization of hemorrhagic adnexal lesions with MR imaging: blinded reader study. Radiology. 186(2):489-94, 1993
Togashi K et al: Endometrial cysts: diagnosis with MR imaging. Radiology. 180(1):73-8, 1991
Zawin M et al: Endometriosis: appearance and detection at MR imaging. Radiology. 171(3):693-6, 1989
Related Anatomy
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References
Tables
Tables
KEY FACTS
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
Endometriotic cyst
"Chocolate" cyst
Definitions
Cystic ovarian mass resulting from repeated hemorrhage of endometrial tissue implants in response to hormonal stimulation
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Hindman N et al: Imaging spectrum of endometriosis (endometriomas to deep infiltrative endometriosis). Radiol Clin North Am. 58(2):275-89, 2020
Moro F et al: Ultrasound imaging in endometriosis. Obstet Gynecol Clin North Am. 46(4):643-59, 2019
Exacoustos C et al: Isolated ovarian endometrioma: a history between myth and reality. J Minim Invasive Gynecol. 25(5):884-91, 2018
Van den Bosch T et al: Ultrasound diagnosis of endometriosis and adenomyosis: state of the art. Best Pract Res Clin Obstet Gynaecol. 51:16-24, 2018
Corwin MT et al: Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology. 271(1):126-32, 2014
Chaudhry S et al: Detection and differential diagnosis of suspected malignant transformation of an endometrioma during pregnancy. BMJ Case Rep. 2013:bcr2012007744, 2013
Khashper A et al: T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 32(4):1047-64, 2012
McDermott S et al: MR imaging of malignancies arising in endometriomas and extraovarian endometriosis. Radiographics. 32(3):845-63, 2012
Siegelman ES et al: MR imaging of endometriosis: ten imaging pearls. Radiographics. 32(6):1675-91, 2012
Lee YR: CT imaging findings of ruptured ovarian endometriotic cysts: emphasis on the differential diagnosis with ruptured ovarian functional cysts. Korean J Radiol. 12(1):59-65, 2011
Tsili AC et al: Malignant transformation of an endometriotic cyst: MDCT and MR findings. J Radiol Case Rep. 5(1):9-17, 2011
Bennett GL et al: Unusual manifestations and complications of endometriosis--spectrum of imaging findings: pictorial review. AJR Am J Roentgenol. 194(6 Suppl):WS34-46, 2010
Dujardin M et al: Cystic lesions of the female reproductive system: a review. JBR-BTR. 93(2):56-61, 2010
Tanaka YO et al: MRI of endometriotic cysts in association with ovarian carcinoma. AJR Am J Roentgenol. 194(2):355-61, 2010
Takeuchi M et al: Susceptibility-weighted MRI of endometrioma: preliminary results. AJR Am J Roentgenol. 191(5):1366-70, 2008
Asch E et al: Variations in appearance of endometriomas. J Ultrasound Med. 26(8):993-1002, 2007
Kinkel K et al: Diagnosis of endometriosis with imaging: a review. Eur Radiol. 16(2):285-98, 2006
Lee SI: Radiological reasoning: imaging characterization of bilateral adnexal masses. AJR Am J Roentgenol. 187(3 Suppl):S460-6, 2006
Fruscella E et al: Sonographic features of decidualized ovarian endometriosis suspicious for malignancy. Ultrasound Obstet Gynecol. 24(5):578-80, 2004
Wu TT et al: Magnetic resonance imaging of ovarian cancer arising in endometriomas. J Comput Assist Tomogr. 28(6):836-8, 2004
Sala EJ et al: Magnetic resonance imaging of benign adnexal disease. Top Magn Reson Imaging. 14(4):305-27, 2003
Zanardi R et al: Staging of pelvic endometriosis based on MRI findings versus laparoscopic classification according to the American Fertility Society. Abdom Imaging. 28(5):733-42, 2003
Glastonbury CM: The shading sign. Radiology. 224(1):199-201, 2002
Modesitt SC et al: Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol. 100(4):788-95, 2002
Alcazar JL: Transvaginal colour Doppler in patients with ovarian endometriomas and pelvic pain. Hum Reprod. 16(12):2672-5, 2001