Extragenital Endometriosis Research Articles

Extragenital endometriosis--a clinicopathological review of a Glasgow hospital experience with case illustrations

The clinicopathological characteristics of 34 cases of extragenital endometriosis (mean age 33.74) presenting to surgeons over a 9-year period at Glasgow Royal Infirmary were reviewed. A total of 379 cases of endometriosis were diagnosed by histology during the period, giving an 8.9% prevalence of extragenital manifestations. Eleven (32.3%) cases were in the intestinal tract, two (5.9%) in the urinary tract and 21 (61.8%) were in other sites, including pfannenstiel scar, inguinal canal, umbilicus and perineum; 52.9% presented to gynaecologists and mean time to diagnosis was 24.54 months (CI: 13.2 - 35.8). Pain was the most common presentation in 76.5% but this was cyclical, reported in only 41.2%. Palpable mass was found in 41.2%, especially in pfannenstial scar (26.5%), suggesting iatrogenic cause. Histology remains the cornerstone of diagnosis and several of the case histories describe delay and diagnostic confusion. Endometriosis is rarely fatal, but continues to challenge patients and clinicians in all specialities in presentation and diagnosis.

COX-2-expression in extragenital endometriosis lesions as a novel therapeutical approach?

Extragenital endometriosis is a rare form of endometriosis. Due to its invasive and metastatic properties it resembles some features of malignant tumours. Cyclooxygenase (COX)-2 is a rate-limiting enzyme in the biosynthesis of prostaglandins and is mainly expressed in inflammatory and malignant processes. In this study we investigated the COX-2 expression in extragenital endometriosis. Tissue was obtained of 13 women with rectal and vaginal endometriosis, scar endometriosis and endometriosis of the omentum majus. The COX-2 expression was investigated by immunohistochemistry. In the glandular epithelium a COX-2 overexpression was found in all cases and in the stroma a weak to moderate COX-2 expression was found in half of the cases. A hormonal therapy at the time of surgery had no influence on the COX-2 expression in extragenital endometriosis. The high COX-2 expression in extragenital endometriosis is believed to be strongly correlated with the pathological abnormalities this of disease.

Endometriosis extragenital y extrapelviana

ObjectiveTo review the cases of extrapelvic and extragenital endometriosis, a relatively infrequent entity, diagnosed and treated in our center. ResultsOf 18 patients with a histological diagnosis of endometriosis from 1996 to 2002, endometriosis was located in the bladder in one patient (5.5%), the cervix in 2 (11.1%), the epiploon in one (5.5%), the abdominal wall in 2 (11.1%), the vagina in 3 (16.5%), the perineum in 3 (16.5%), the umbilicus in 3 (16.5%) and the intestinal tract in 3 patients (16.5%), of which 2 involved the rectosigmoid. ConclusionsExtrapelvic endometriosis (cervix, vagina, vulva and perineum) is uncommon and extragenital localizations (urinary, intestinal, abdominal wall, etc.) are highly infrequent. Endometriosis lesions have been described in almost all organs.

Analysis of Polymorphic Alleles of the Genes Encoding the Phase 1 and 2 Detoxication Enzymes in Patients with Endometriosis

Polymorphysms of the three genes encoding phase 1 (CYP1A1, mEPHX1, and CYP2E1) and the three genes encoding phase 2 (NAT2, GSTM1, and GSTT1) xenobiotic detoxication enzymes were typed by use of PCR in 74 patients with extragenital endometriosis. Distribution of the CYP1A1, mEPHX1, CYP2E1, NAT2,and GSTM1polymorphic alleles in the patient group corresponded to that in the control group. At the same time, functionally defective genotypes GSTM1 0/0, NAT2 S/S; GSTM1 0/0, GSTT1 0/0; and GSTT1 0/0, NAT2 S/S were three, four, and eight times more frequent among the patients than in healthy individuals. This observation suggests the existence of a distinct association between the functionally defective alleles of the phase 2 xenobiotic detoxication and endometriosis. Possible mechanisms underlying this association are discussed. It is suggested that typing of the NAT2, GSTM1, and GSTT1 genes can be useful for the assessment of the predisposition to endometriosis.

The tactics for extragenital endometriosis with nephroptosis management

The material on 45 patients with nephroptosis and genital endometriosis is depicted. The diagnosis was done with the help of compliance analysis, USG, hysterogramm, laparoscopy, excretory urography. All patients were performed nephropexy, with further therapy of endometriosis. We have found the syndrome of cross-aggravation in these patients that had the influence on treatment tactics. 23 patients in 10 years need no surgical treatment for endometriosis; that can allow us recommend to start the management with nephropexy if there are the indications.

Different types of extragenital endometriosis: a review.

Endometriotic growth may appear in any structure in the body. As well as affecting the internal genitalia, lesions are not uncommon in the bowel, urinary tract and thorax and reports of a number of cases at rarer sites have been published. This review is based on more than 1000 publications on the subject, that allows an overview of the appearance of the disease in different organs.

Malignant mixed mullerian tumor arising in extragenital endometriosis: Report of a case and review of the literature

A primary malignant mixed Mullerian tumor (MMMT) was found in the wall of the rectum of a 67-year-old female. The uterus, fallopian tubes, and ovaries had been previously excised for benign disease. The tumor was associated with foci of benign endometriosis. A literature review of extragenital MMMTs indicates that these are extremely rare tumors. This case supports the theory that endometriosis may serve as a progenitor to extraendometrial malignancy.

Results of diagnostic pelviscopy in cases of chronic recurrent pelvic disease.

During the last two years we have performed diagnostic pelviscopy in 90 patients suffering from a syndrome of chronic repeated pelvic disease. In 44 patients extragenital endometriosis was diagnosed as the causing factor. In 15 cases we found wide-spread adhesions in the region of the lower pelvis after preceeding laparotomies. Only in 12 patients pelvic-alterations caused by chronic inflammatory processes of the adnexa with peritubal adhesions were discovered. As these results show extragenital endometriosis represents in far more cases as generally believed the cause of gynecological pains. We want to give special emphasis to the diagnosis and treatment of this disease.