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Early implants look like small, flat dark patches or flecks of blue or black paint sprinkled on the pelvic surfaces. The small patches may remain unchanged, become scar tissue or spontaneously disappear over a period of months. Endometriosis may invade the ovary, producing blood filled cysts called endometriomas. With time, the blood darkens to a deep, reddish brown or tarry color, giving rise to the description "chocolate cyst." These may be smaller than a pea or larger than a grapefruit.
In some cases, bands of fibrous tissue called adhesions may bind the uterus, tubes, ovaries, and nearby intestines together. The endometrial tissue may also grow into the walls of the intestine; but although it may invade neighboring tissue, endometriosis is not a cancer.
Fig 1. Schematic, showing a chocolate cyst (endometrioma) in the right ovary; and peritubal adhesions because of endometriosis
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
