| Summary: | In the present pictorial we show the ultrasonographic appearances of endometriosis
in atypical sites. Scar endometriosis may present as a hypoechoic solid nodule with hyperechoic
spots while umbilical endometriosis may appear as solid or partially cystic areas with ill-defined
margins. In the case of endometriosis of the rectus muscle, ultrasonography usually demonstrates
a heterogeneous hypoechogenic formation with indistinct edges. Inguinal endometriosis is quite
variable in its ultrasonographic presentation showing a completely solid mass or a mixed solid
and cystic mass. The typical ultrasonographic finding associated with perineal endometriosis is
the presence of a solid lesion near to the episiotomy scar. Under ultrasonography, appendiceal
endometriosis is characterized by a solid lesion in the wall of the small bowel, usually well defined.
Superficial hepatic endometriosis is characterized by a small hypoechoic lesion interrupting the hepatic
capsula, usually hyperechoic. Ultrasound endometriosis of the pancreas is characterized by a small
hypoechoic lesion while endometriosis of the kidney is characterized by a hyperechoic small nodule.
Diaphragmatic endometriosis showed typically small hypoechoic lesions. Only peripheral nerves can
be investigated using ultrasound, with a typical solid appearance. In conclusion, ultrasonography
seems to have a fundamental role in the majority of endometriosis cases in “atypical” sites, in all the
cases where “typical” clinical findings are present.
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