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Publication
Endometriose – epidemiologia, fisiopatologia e revisão clínica e radiológica
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Advisor(s)
Abstract(s)
A endometriose é definida como a presença de tecido endometrial em localização ectópica. Ocorre predominantemente em
mulheres em idade fértil, apresentando-se clinicamente com algia pélvica, dispareunia e infertilidade. As localizações mais habituais
são o ovário, o miométrio (adenomiose) e o torus uterino, podendo surgir em outros órgãos, como a bexiga, o intestino ou pulmão.
São consideradas actualmente três teorias de histogénese, a metastática, por menstruação retrógrada; a teoria de diferenciação
metaplástica de superfícies serosas; e a de indução da diferenciação de tecido mesenquimatoso em tecido endometrial.
Embora se trate de uma doença benigna, estão descritas situações de malignização, sendo o carcinoma endometrióide do ovário
o mais frequentemente associado a endometriose.
A avaliação radiológica faz-se por ultrassonografia e ressonância magnética. As lesões ováricas apresentam-se como quistos, com
características benignas, frequentemente multiloculados e bilaterais, com focos hiperecogénocos parietais, traduzindo depósitos
de colesterol.
As presenças de critérios de malignidade (paredes espessas com nódulos, vascularização, ascite) são importantes no diagnóstico
de transformação maligna.
Endometriosis is defined as the presence of endometrial tissue in ectopic location. It affects mainly women in reproductive years presenting clinically as pelvic pain, dyspareunia and infertility. The most common locations are the ovary, myometrium (adenomyosis) and uterine torus, but it can appear in other organs such as the bladder, bowel and lung. Actually, three histogenetic theories are considered, the metastatic, by retrograde menstruation; the metaplastic differentiation of serosal surfaces; and the induction theory, from mesenchymal tissue into endometrial tissue. Despite we are dealing with a benign disease, cases of malignization are referred in the literature, being the endometrioid carcinoma of the ovary the most frequently related with endometriosis. The radiologic evaluation is performed by ultrasound and magnetic resonance imaging. The ovarian lesions present as cysts, with benign characteristics, frequently multiloculated and bilateral, with parietal hyperechoic foci, manifesting the presence of cholesterol deposits. The presence of malignancy criteria (thick walls with irregularities or pappilary projections, vascularity, ascites) are important in the diagnosis of malignant transformation.
Endometriosis is defined as the presence of endometrial tissue in ectopic location. It affects mainly women in reproductive years presenting clinically as pelvic pain, dyspareunia and infertility. The most common locations are the ovary, myometrium (adenomyosis) and uterine torus, but it can appear in other organs such as the bladder, bowel and lung. Actually, three histogenetic theories are considered, the metastatic, by retrograde menstruation; the metaplastic differentiation of serosal surfaces; and the induction theory, from mesenchymal tissue into endometrial tissue. Despite we are dealing with a benign disease, cases of malignization are referred in the literature, being the endometrioid carcinoma of the ovary the most frequently related with endometriosis. The radiologic evaluation is performed by ultrasound and magnetic resonance imaging. The ovarian lesions present as cysts, with benign characteristics, frequently multiloculated and bilateral, with parietal hyperechoic foci, manifesting the presence of cholesterol deposits. The presence of malignancy criteria (thick walls with irregularities or pappilary projections, vascularity, ascites) are important in the diagnosis of malignant transformation.
Description
Keywords
Endometriose Endometrioma Adenomiose Infertilidade Endometriosis Endometrioma Adenomyosis Infertility
Citation
Cláudia Campos; Márcio Navalho; Teresa Margarida Cunha. Endometriosis – Epidemiology, Fisiopathology and Review of the Clinical and Imagiological Features, Acta Radiológica Portuguesa, 20, 80, 67-77, 2008.