‘Blood On The Tracks’ from corpora lutea to endometriomas


  • Bob Dylan: Blood On The Tracks. Columbia Records LTD, USA, 1975.

Dr P Vercellini, Department of Obstetrics and Gynaecology, Istituto ‘Luigi Mangiagalli’, University of Milan, Via Commenda 12, 20122 Milan, Italy. Email paolo.vercellini@unimi.it


Objective  To detect a direct transition from a haemorrhagic corpus luteum to an endometriotic cyst by serial transvaginal ultrasonographic scans.

Design  Prospective observational study.

Setting  An academic tertiary care and referral centre for women with endometriosis.

Population  One hundred and nine women younger than 40 years, with regular menstrual cycles, undergoing first-line surgery for endometriomas, and not wanting postoperative oral contraception.

Methods  Three-monthly transvaginal ultrasonography during the luteal phase for 2 years after surgery.

Main outcome measure  Sonographic identification of progression from a haemorrhagic corpus luteum to a recurrent endometriotic cyst.

Results  A haemorrhagic corpus luteum was identified in 13 women. Serial ultrasonographic scans demonstrated transition to an endometriotic cyst in 11 (85%) instances and resorption in two. A unilateral endometriotic cyst without previous detection of a cystic corpus luteum was observed in 14 women.

Conclusions  Bleeding from a corpus luteum appears to be a critical event in the development of endometriomas.