What are less common sites of anatomic spread of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Although uncommon, interference in the genitourinary tract by endometriosis can affect the bladder, ureters, and kidneys by invasion, compression, or scarring. Medical therapy has less than satisfactory results, and surgical intervention is often required.

Uncommon sites include incisional scars, the umbilicus, and the thoracic cavity. Catamenial or cyclic pneumothorax can cause hemoptysis. Remember that ectopic endometrial tissue theoretically can undergo malignant transformation; histologic evaluation may be necessary. Significant predictive factors for the presence of malignant transformation of endometriosis appear to include age older than 49 years and cysts that are multilocular and have solid components. [26] Although elevated, levels of serum cancer antigen 125 (CA-125) do not appear to be a significant predictor of malignant transformation of endometriosis.


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