Abstract
Background: In the context of extragenital endometriosis, the gastrointestinal, urinary tract, abdominal wall, and thorax localizations are considered relatively frequent, while the umbilical, inguinal, sciatic nerve, liver, and pancreas are instead “rare”. Methods: Online searches were carried out in PubMed database of the last 20 years for these terms: extragenital endometriosis, umbilical endometriosis, inguinal endometriosis, sciatic nerve endometriosis, hepatic and pancreatic endometriosis. The following exclusion criteria were used: (1) Personal surgical history unspecified. (2) Nonspecific histological diagnosis for each type of endometriosis examined. (3) Inability to distinguish between the personal series of the author and the case reports described. (4) Proceedings of scientific meetings were not included. Tables that are easy to consult were compiled. Results: 810 titles were found among which 162 studies were selected for reading in full text and finally 114 papers were included, which met the objective of the revision. The so-called “rare” forms of extragenital endometriosis show an unsuspected frequency, an extreme variability of presentation, and uncertain treatment guidelines. Discussion: Gynecologists, general surgeons, and neurologists should be well acquainted with these pathologies to avoid confusing diagnostic paths and to set up adequate therapies.
Highlights
Extrapelvic endometriosis is a challenging disorder that affects a small percentage of women suffering from endometriosis, approximately 5–8.9%, according to Markham et al [1]
The search included a combination of the various term: extragenital endometriosis, umbilical endometriosis, inguinal endometriosis, sciatic nerve endometriosis, hepatic and pancreatic endometriosis. 810 titles were found among which 162 studies were selected for reading in full text and 114 papers were included, which met the objective of the revision: 31 for umbilical andometriosis, 35 for inguinal, 22 for sciatic nerve, 15 for hepatic and 10 for pancreatic
For each of the investigated locations, we focused on the number of patients presented, the symptoms they complained of, the interventions undergone previously, on the coexistence of genito-pelvic endometriosis, on the advanced pathogenetic hypotheses and on the follow-up
Summary
Extrapelvic endometriosis is a challenging disorder that affects a small percentage of women suffering from endometriosis, approximately 5–8.9%, according to Markham et al [1] This condition presents with a variety of symptoms depending upon the organ involved and severity of the lesion. Locations such the gastrointestinal tract, urinary tract, abdominal wall and thorax are considered “common” Other sites such as the umbilicus, inguinal area, pelvic nerves, liver, and pancreas are considered “rare”. Even if these localizations are rare, it is important to know how to recognize them to spare the patient disorienting diagnostic pathways and to be able to establish prompt and effective therapies. This manuscript aims to provide an overview of what is currently known about this unusual condition and to compare pathogenetic hypotheses and therapeutic choices with prognosis for each of these localizations: umbilical, inguinal, sciatic nerve, hepatic and pancreatic
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