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Abdominal Wall Endometriosis: Clinical Presentation and Imaging Features with Emphasis on Sonography

Jan-Hein J. Hensen1, Adriaan C. Van Breda Vriesman2 and Julien B. C. M. Puylaert1

1 Department of Radiology, MCH Westeinde Hospital, The Hague, Lijnbaan 32, PO Box 432, NL-2501 CK, The Netherlands.
2 Department of Radiology, Rijnland Hospital, Leiderdorp, NL-2350 CC, The Netherlands.


Figure 1
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  		Fig. 1 —Microscopic appearance of abdominal wall endometriosis in 29-year-old woman. Medium-power photomicrograph shows endometriotic glands (E) next to muscular tissue of abdominal wall (M). (H and E, original magnification, x32)

 

Figure 2
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  		Fig. 2A —27-year-old woman with abdominal wall endometriosis. Transverse sonogram shows hypoechoic solid 3-cm mass with scattered internal echoes. Mass is confined to rectus abdominis sheath.

 

Figure 3
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  		Fig. 2B —27-year-old woman with abdominal wall endometriosis. Transverse power Doppler sonography reveals internal vascularity within lesion.

 

Figure 4
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  		Fig. 3A —41-year-old woman with abdominal wall endometriosis. Extended-field-of-view sonogram in sagittal plane reveals heterogeneous hypoechoic solid mass infiltrating in both muscular abdominal wall and subcutaneous fat.

 

Figure 5
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  		Fig. 3B —41-year-old woman with abdominal wall endometriosis. Power Doppler sonogram shows internal vascularity.

 

Figure 6
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  		Fig. 3C —41-year-old woman with abdominal wall endometriosis. Unenhanced CT shows lesion (arrowheads) in right rectus sheath to be isodense to muscular tissue.

 

Figure 7
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  		Fig. 3D —41-year-old woman with abdominal wall endometriosis. Contrast-enhanced CT shows slight enhancement of lesion (arrowheads).

 

Figure 8
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  		Fig. 4A —43-year-old woman with abdominal wall endometriosis. Axial T1-weighted spin-echo MR image shows lesion (arrowheads) in subcutaneous fat of right lower abdominal wall. Lesion is isointense to muscle.

 

Figure 9
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  		Fig. 4B —43-year-old woman with abdominal wall endometriosis. Axial T2-weighted fat-saturated fast spin-echo MR image depicts lesion (arrowheads) as heterogeneous high-signal-intensity mass.

 

Figure 10
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  		Fig. 4C —43-year-old woman with abdominal wall endometriosis. Axial T1-weighted fat-saturated spin-echo MR image after injection of contrast medium shows strong enhancement of lesion (arrowheads).

 

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