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CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(03): 184-190
DOI: 10.1055/s-0040-1720946
Original Article

Endometriosis: A Clinicopathological Study in a Tertiary Care Hospital

Shubha P. Bhat
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
,
Sajitha Kaliyat
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
,
Kishan Prasad Hosapatna Laxminarayana
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
,
Teerthanath Srinivas
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
,
Krishna Prasad Holalkere Venugopala
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
,
Jayaprakash Kubalady Shetty
1   Department of Pathology, K.S Hegde Medical Academy, Nitte-Deemed to be University, Mangalore, Karnataka, India
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Abstract

Background Endometriosis (EM) is an estrogen-dependent disease characterized by the presence of endometrial gland and stroma outside the uterus. It is commonly seen in the reproductive age group and is a leading cause of infertility. Patients present with chronic pelvic pain, menstrual abnormalities, dyspareunia, or mass per abdomen. Surgical excision is the treatment of choice with postoperative medications and progesterone agents.

Aims and Objectives This study aims at determining the distribution of EM in terms of age, parity, symptoms, site, morphological features. We also analyzed the management of EM in these cases.

Methodology This is a retrospective study done in a tertiary care hospital in Mangalore, India. The case records of 77 histopathologically confirmed cases of EM during the 7 years between June 2012 and May 2019 were studied. Demographic profiles, parity, presenting complaints, site of the lesion, morphological features, treatment given, follow-up, and recurrence were noted and analyzed.

Results Of the 77 patients with EM, the most common age group was the fourth decade (40%). The majority (31, 40.25%) of the patients in this study were nulliparous. Chronic pelvic pain was the most common symptom. The most frequent site was ovary.

Conclusion The most frequent site of EM is ovary, leading to infertility. With the advent of laparoscopy, early diagnosis and excision have been feasible. The histopathological examination should be done for confirmation. Awareness of this disease among health care professionals is necessary whenever a woman in reproductive age presents with chronic pelvic pain and infertility.

Keywords

endometriosis - site - diagnosis - treatment


Publication History

Article published online:
23 November 2020

© 2020. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Agarwal N, Subramanian A. Endometriosis - morphology, clinical presentations and molecular pathology. J Lab Physicians 2010; 2 (01) 1-9
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Mishra VV, Gaddagi RA, Aggarwal R, Choudhary S, Sharma U, Patel U. Prevalence, characteristics and management of endometriosis amongst infertile women: a one year retrospective study. J Clin Diagn Res 2015; 9 (06) QC01-QC03
    PubMedGoogle Scholar
  • 3 Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci 2008; 1127: 92-100
    CrossrefPubMedGoogle Scholar
  • 4 Brosens I, Puttemans P, Benagiano G. Endometriosis: a life cycle approach?. Am J Obstet Gynecol 2013; 209 (04) 307-316
    CrossrefPubMedGoogle Scholar
  • 5 Satyanarayana MA, Sushma V, Kumar KP, Kumar VS, Murthy KR, Asha T. Endometriosis: A clinicopathological study of 29 cases. J Clin Diagn Res 2018; 12 (05) 5-9
    Google Scholar
  • 6 Saleem A, Navarro P, Munson JL, Hall J. Endometriosis of the appendix: Report of three cases. Int J Surg Case Rep 2011; 2 (02) 16-19
    CrossrefPubMedGoogle Scholar
  • 7 Almeida DP Filho, Oliveira LJ, Amaral VF. Accuracy of laparoscopy for assessing patients with endometriosis. Sao Paulo Med J 2008; 126 (06) 305-308
    CrossrefPubMedGoogle Scholar
  • 8 Amaral VF, Ferriani RA, Sá MF. et al. Positive correlation between serum and peritoneal fluid CA-125 levels in women with pelvic endometriosis. Sao Paulo Med J 2006; 124 (04) 223-227
    CrossrefPubMedGoogle Scholar
  • 9 Rawala MS, Khaliq MF, Iqbal MA, Naqvi ST, Farhan K, Myers A, et al. A rare case of cyclical hemothorax: thoracic endometriosis syndromeCase Rep Pulmonol 2018;(e-pub ahead of print). doi: https://doi.org/10.1155/2018/9830797
  • 10 Azizad-Pinto P, Clarke D. Thoracic endometriosis syndrome: case report and review of the literature. Perm J 2014; 18 (03) 61-65
    CrossrefPubMedGoogle Scholar
  • 11 Koninckx PR, Ussia A, Keckstein J, Wattiez A, Adamyan L. Epidemiology of subtle, typical, cystic, and deep endometriosis: a systematic review. Gynecol Surg 2016; 13: 457-467
    CrossrefGoogle Scholar
  • 12 Dovey S, Sanfilippo J. Endometriosis and the adolescent. Clin Obstet Gynecol 2010; 53 (02) 420-428
    CrossrefPubMedGoogle Scholar
  • 13 Vasquez G, Cornillie F, Brosens IA. Peritoneal endometriosis: scanning electron microscopy and histology of minimal pelvic endometriotic lesions. Fertil Steril 1984; 42 (05) 696-703
    CrossrefPubMedGoogle Scholar
  • 14 Oliveira FR, Dela Cruz C, Del Puerto HL, Vilamil QTMF, Reis FM, Camargos AF. Stem cells: are they the answer to the puzzling etiology of endometriosis?. Histol Histopathol 2012; 27 (01) 23-29
    PubMedGoogle Scholar
  • 15 Lin J, Xiang D, Zhang J-L, Allickson J, Xiang C. Plasticity of human menstrual blood stem cells derived from the endometrium. J Zhejiang Univ Sci B 2011; 12 (05) 372-380
    CrossrefPubMedGoogle Scholar
  • 16 Cornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR. Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 1990; 53 (06) 978-983
    CrossrefPubMedGoogle Scholar
  • 17 Stephansson O, Kieler H, Granath F, Falconer H. Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome. Hum Reprod 2009; 24 (09) 2341-2347
    CrossrefPubMedGoogle Scholar
  • 18 Soliman NF, Hillard TC. Hormone replacement therapy in women with past history of endometriosis. Climacteric 2006; 9 (05) 325-335
    CrossrefPubMedGoogle Scholar
  • 19 Tahmasebi F, Nath R, Sokolovsky N. et al. Incidental finding of raised CA125: a cause for concern?. Crit Care Obst Gyne 2018; 5 (01) 1-5
    Google Scholar
  • 20 Gruppo Italiano per lo Studio dell’Endometriosi. Relationship between stage, site and morphological characteristics of pelvic endometriosis and pain. Hum Reprod 2001; 16 (12) 2668-2671
    CrossrefPubMedGoogle Scholar
  • 21 Nair SS, Nayar J. Thoracic endometriosis syndrome: a veritable Pandora’s Box. J Clin Diagn Res 2016; 10 (04) QR04-QR08
    PubMedGoogle Scholar