What are the most common sites of involvement for endometriosis?

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

The most common sites of involvement found during laparoscopy are the following, in descending order (see the following images):

  • Ovaries

  • Posterior cul-de-sac

  • Broad ligament

  • Uterosacral ligament

  • Rectosigmoid colon

  • Bladder

  • Distal ureter

The following images are from various sites of endometriosis involvement.

Endometriosis. Red lesions on various organs. Endometriosis. Red lesions on various organs.
Endometriosis. Red lesions on the sigmoid colon an Endometriosis. Red lesions on the sigmoid colon and cul-de-sac.
Peritoneal erosions and adhesions in the posterior Peritoneal erosions and adhesions in the posterior cul-de-sac. These are typical of more severe endometriosis.
Typical appearance of minimal endometriosis on the Typical appearance of minimal endometriosis on the uterosacral ligaments. Note that some are pigmented (contain hemosiderin), whereas others are not.

In a study of low-grade ovarian endometrial adenocarcinomas, KRAS mutations were identified in 29% of endometriosis-associated tumors but only 3% in which endometriosis was not identified. This may be relevant to future targeted therapies. [56]


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