子宫内膜异位症是一种常见的病理学，主要影响年轻女性。当有典型的表现时，可以通过影像学，特别是MRI来容易地进行诊断。良性子宫内膜异位症转变为子宫内膜异位症相关肿瘤的情况很少见。其病理生理学是复杂的且存在争议。子宫内膜样癌和透明细胞癌是主要的组织学亚型。我们的目标是回顾主要的影像学特征，特别是在MRI上，以帮助识别卵巢或非卵巢子宫内膜异位症相关肿瘤，因为这在手术管理前可能是相关的。要点• 良性子宫内膜异位症转变为子宫内膜异位症相关肿瘤的情况很少见。• MRI对显示与卵巢肿瘤相关的子宫内膜异位症病变非常有用。• 在复杂子宫内膜囊肿的评估中应使用减影图像。©2023. European Society of Radiology (ESR).

Endometriosis is a frequent pathology mostly affecting women of young age. When typical aspects are present, the diagnosis can easily be made at imaging, especially at MRI. Transformation of benign endometriosis to endometriosis-associated neoplasms is rare. The physiopathology is complex and remains controversial. Endometrioid carcinoma and clear cell carcinoma are the main histological subtypes. Our goal was to review the main imaging characteristics that should point to an ovarian or extra-ovarian endometriosis-related tumor, especially at MRI, as it may be relevant prior to surgical management.Key points• Transformation of benign endometriosis to endometriosis-associated neoplasms is rare.• MRI is useful when displaying endometriosis lesions associated to an ovarian tumor.• Subtraction imaging should be used in the evaluation of complex endometriomas.© 2023. European Society of Radiology (ESR).