Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review

Li-li Chu,1 Meng Wu,1 Wei-li Yang,2 Ling-hua Cong,3 Lu Li2 1Department of Ultrasound Medicine, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of China; 2Obstetrics and Gynecology, People’s Hospital Affiliated to Ningbo Univers...

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Main Authors: Chu LL, Wu M, Yang WL, Cong LH, Li L
Format: Article
Language:English
Published: Dove Medical Press 2025-05-01
Series:International Journal of Women's Health
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Online Access:https://www.dovepress.com/contrast-enhanced-ultrasound-findings-of-peritoneal-polypoid-endometri-peer-reviewed-fulltext-article-IJWH
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author Chu LL
Wu M
Yang WL
Cong LH
Li L
author_facet Chu LL
Wu M
Yang WL
Cong LH
Li L
author_sort Chu LL
collection DOAJ
description Li-li Chu,1 Meng Wu,1 Wei-li Yang,2 Ling-hua Cong,3 Lu Li2 1Department of Ultrasound Medicine, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of China; 2Obstetrics and Gynecology, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of China; 3Department of Pathology, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Li-li Chu, Department of Ultrasound Medicine, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, No. 251 Baizhang East Road, Ningbo, Zhejiang, People’s Republic of China, Email lilychu380356745@163.comAbstract: Polypoid endometriosis (PEM) is a rare and distinctive variant of endometriosis, with ectopic endometrium presenting as a polypoid appearance. Due to the irregular shape of the mass on imaging, accompanied by obvious blood flow signals and often with elevated tumor marker CA125, it is prone to be misdiagnosed as a malignant tumor. We report a 43-year-old female with a history of ovarian endometriosis, in whom a heterogeneous echo mass was found in the pelvic cavity. The mass, located on the peritoneum and adhered to the omentum majus, had an irregular shape and prominent blood flow signals, complicating the imaging findings. Both contrast-enhanced computed tomography and magnetic resonance examinations identified the mass as a malignant ovarian tumor, whereas conventional ultrasound failed to determine its nature. However, venous contrast-enhanced ultrasound (CEUS) revealed benign characteristics, such as uniform enhancement of the solid portion and slow, consistent regression. The postoperative pathology confirmed that it was PEM. PEM is difficult to diagnose preoperatively due to its rarity, non-specific symptoms, and complex imaging features. This case, by summarizing and analyzing the CEUS image characteristics of peritoneal PEM, fills the gap in this new technology of CEUS, expands the possibilities of non-invasive imaging diagnosis, and reviews the relevant literature published to emphasize its features, pathogenesis, diagnostic methods, and treatment approaches, thereby enhancing the understanding and management of this condition.Keywords: endometriosis, polypoid endometriosis, ovarian malignancy, venous contrast-enhanced ultrasound
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series International Journal of Women's Health
spelling doaj-art-933f8d4e15994a888ff7236c9de08ac82025-08-20T03:26:57ZengDove Medical PressInternational Journal of Women's Health1179-14112025-05-01Volume 17Issue 115571562103424Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature ReviewChu LL0Wu M1Yang WL2Cong LH3Li L4Department of Ultrasound MedicineDepartment of Ultrasound MedicineObstetrics and GynecologyDepartment of PathologyObstetrics and GynecologyLi-li Chu,1 Meng Wu,1 Wei-li Yang,2 Ling-hua Cong,3 Lu Li2 1Department of Ultrasound Medicine, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of China; 2Obstetrics and Gynecology, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of China; 3Department of Pathology, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Li-li Chu, Department of Ultrasound Medicine, People’s Hospital Affiliated to Ningbo University, Ningbo Yinzhou People’s Hospital, No. 251 Baizhang East Road, Ningbo, Zhejiang, People’s Republic of China, Email lilychu380356745@163.comAbstract: Polypoid endometriosis (PEM) is a rare and distinctive variant of endometriosis, with ectopic endometrium presenting as a polypoid appearance. Due to the irregular shape of the mass on imaging, accompanied by obvious blood flow signals and often with elevated tumor marker CA125, it is prone to be misdiagnosed as a malignant tumor. We report a 43-year-old female with a history of ovarian endometriosis, in whom a heterogeneous echo mass was found in the pelvic cavity. The mass, located on the peritoneum and adhered to the omentum majus, had an irregular shape and prominent blood flow signals, complicating the imaging findings. Both contrast-enhanced computed tomography and magnetic resonance examinations identified the mass as a malignant ovarian tumor, whereas conventional ultrasound failed to determine its nature. However, venous contrast-enhanced ultrasound (CEUS) revealed benign characteristics, such as uniform enhancement of the solid portion and slow, consistent regression. The postoperative pathology confirmed that it was PEM. PEM is difficult to diagnose preoperatively due to its rarity, non-specific symptoms, and complex imaging features. This case, by summarizing and analyzing the CEUS image characteristics of peritoneal PEM, fills the gap in this new technology of CEUS, expands the possibilities of non-invasive imaging diagnosis, and reviews the relevant literature published to emphasize its features, pathogenesis, diagnostic methods, and treatment approaches, thereby enhancing the understanding and management of this condition.Keywords: endometriosis, polypoid endometriosis, ovarian malignancy, venous contrast-enhanced ultrasoundhttps://www.dovepress.com/contrast-enhanced-ultrasound-findings-of-peritoneal-polypoid-endometri-peer-reviewed-fulltext-article-IJWHendometriosispolypoid endometriosisovarian malignancyvenous contrast-enhanced ultrasound
spellingShingle Chu LL
Wu M
Yang WL
Cong LH
Li L
Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
International Journal of Women's Health
endometriosis
polypoid endometriosis
ovarian malignancy
venous contrast-enhanced ultrasound
title Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
title_full Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
title_fullStr Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
title_full_unstemmed Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
title_short Contrast-Enhanced Ultrasound Findings of Peritoneal Polypoid Endometriosis: A Case Report and Literature Review
title_sort contrast enhanced ultrasound findings of peritoneal polypoid endometriosis a case report and literature review
topic endometriosis
polypoid endometriosis
ovarian malignancy
venous contrast-enhanced ultrasound
url https://www.dovepress.com/contrast-enhanced-ultrasound-findings-of-peritoneal-polypoid-endometri-peer-reviewed-fulltext-article-IJWH
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AT conglh contrastenhancedultrasoundfindingsofperitonealpolypoidendometriosisacasereportandliteraturereview
AT lil contrastenhancedultrasoundfindingsofperitonealpolypoidendometriosisacasereportandliteraturereview