Understanding Endometriomas: Ultrasound & color Doppler Findings, Symptoms, and Treatment

An endometrioma, also called a chocolate cyst, is an ovarian cyst formed by endometrial tissue in women with endometriosis. It typically contains old, dark blood, leading to a characteristic ground-glass appearance on ultrasound. On transabdominal ultrasound, the endometrioma appears as a well-defined, cystic mass around 4 cm in size, with no internal septations or nodules. Transvaginal ultrasound provides clearer details, showing the cyst’s thick walls and homogenous echogenicity. Color Doppler typically reveals no internal blood flow, distinguishing it from malignant cysts.
Endometriomas are benign but can cause pelvic pain and affect fertility. While asymptomatic cases may be monitored with regular ultrasounds, larger or symptomatic cysts often require surgical removal. Medical management, including hormonal therapy, can help control symptoms and prevent recurrence.
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