Endometriosis and Genital Anomalies:Some Histogenetic Aspects of External Endometriosis

Acién, Pedro

doi:10.1159/000298899

Cited by 21 publications

(12 citation statements)

References 15 publications

(19 reference statements)

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“…These alterations, moreover, are identical in patients with adenomyosis, thus supporting the concept that endometriosis and adenomyosis are the same diseases and that the defect is primarily at uterine level. Nevertheless, it has also been shown that endometriosis is more frequent in patients with Müllerian anomalies (Nawroth et al, 2006) and other genital anomalies (Acién, 1986).…”

Section: Discussionmentioning

confidence: 99%

Embryologic origin of endometriosis: Analysis of 101 human female fetuses

Signorile

Baldi

Bussani

et al. 2012

Journal Cellular Physiology

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The etiology of endometriosis, a gynecological disease characterized by the presence of endometrial glands and stroma outside the uterine cavity, is still unknown. Our research group has recently demonstrated the presence of ectopic endometrium in human female fetuses at different gestational ages. In this manuscript we describe four new cases of fetal endometriosis found among a series of 52 female fetuses analyzed at autopsy. The anatomical localization of this ectopic endometrium, and its histological and immunohistochemical characteristics are depicted. We suggest that endometriosis is caused by dislocation of primitive endometrial tissue outside the uterine cavity during organogenesis. The clinical and pathological implications of these findings are discussed.

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Section: Discussionmentioning

confidence: 99%

Embryologic origin of endometriosis: Analysis of 101 human female fetuses

Signorile

Baldi

Bussani

et al. 2012

Journal Cellular Physiology

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“…Age is a risk factor for endometriosis (usually after 19-20 years of age); if endometriosis occurs before 19-20 years of age, an obstructive genital malformation should be ruled [48–51]. Other risk factors include race, socioeconomic status, height, and weight.…”

Section: Evolutive Biology: Etiopathogenesis and Physiopathologymentioning

confidence: 99%

Endometriosis: A Disease That Remains Enigmatic

Acién

Velasco

2013

ISRN Obstetrics and Gynecology

131

123

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Endometriosis, a gynecologic pathology, is defined by the presence of a tissue similar to uterine endometrium, which is located in places other than physiologically appropriate. These endometrial heterotopic islets contain glands and stroma and are functionally capable of responding to exogenous, endogenous, or local hormonal stimuli. Endometriosis affects 8%–10% of women of reproductive age; in 30% of the women, the condition is associated with primary or secondary infertility. In several instances, endometriosis persists as a minimal or mild disease, or it can resolve on its own. Other cases of endometriosis show severe symptomatology that ends when menopause occurs. Endometriosis can, however, reactivate in several postmenopausal women when iatrogenic or endogenous hormones are present. Endometriosis is occasionally accompanied by malignant ovarian tumors, especially endometrioid and clear cell carcinomas. Its pathogenesis is widely debated, and its variable morphology appears to represent a continuum of individual presentations and progressions. Endometriosis has no pathognomonic signs or symptoms; it is therefore difficult to diagnose. Because of its enigmatic etiopathogenesis, there is currently no satisfactory therapy for all patients with endometriosis. Treatments include medications, surgery, or combined therapies; currently, the only procedures that seem to cure endometriosis are hysterectomy and bilateral salpingo-oophorectomy. In this paper, we review the most controversial and enigmatic aspects of this disease.

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“…The most frequently proposed pathogenetic mechanism is tubal regurgitation during menstrual cycle, which however cannot explain all clinical forms of this disease (Sampson, 1927; Bulun, 2009). Indeed, occurrence of endometriosis was described in patients with Rokitansky–Kuster–Hauser syndrome who does not have functioning endometrial tissue (Acien, 1986; Cho et al, 2009) as well as in male patients with endometriosis of the prostate, bladder, and the abdominal wall (Schrodt et al, 1980; Beckman et al, 1985; Martin and Hauck, 1985). In this regard, the theory of transformation of the vestigial tissue of Müllerian or Wolfian origin and the coelomic metaplasia theory can explain the origin of distinct entities of endometriotic lesions as well as development of particular types of ovarian neoplasms (Ridley, 1968; Suginami, 1991; Varma et al, 2004; Mandai et al, 2009; Wei et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Identification of Displaced Endometrial Glands and Embryonic Duct Remnants in Female Fetal Reproductive Tract: Possible Pathogenetic Role in Endometriotic and Pelvic Neoplastic Processes

Joliniere¹,

Ayoubi²,

Lesec³

et al. 2012

Front. Physio.

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Background: Recent findings strongly promoted the hypothesis that common pelvic gynecological diseases including endometriosis and ovarian neoplasia may develop de novo from ectopic endometrial-like glands and/or embryonic epithelial remnants. To verify the frequency, the anatomical localization and the phenotype of misplaced endometrial tissue along the fetal female reproductive tract, histological and immunohistochemical analyses of uteri, fallopian tubes, and uterosacral ligaments were performed. Methods: Reproductive organs were collected from seven female fetuses at autopsy, five of them from gestational ages between 18 and 26 weeks and two fetuses with gestational ages of 33 and 36 weeks deceased of placental anomalies. Serial sections from areas containing ectopic glands and embryonic duct residues were analyzed by histological and immunohistochemical procedures. Results: Numerous ectopic endometrial glands and stroma were detected in the myometrium in two fetuses with low levels of expression of estrogen receptor-alpha (ER-α) and progesterone receptors (PR). The embryonic ducts were localized in the uterine broad and ovarian ligaments and under the fallopian tube serosa in six fetuses. Low levels of steroid receptors expression were found in the embryonic residues, whereas the carcino-embryonic antigen (CEA) and the tumor marker Ca 125 were not detected. The embryonic residues stromal component strongly expressed the CD 10 and vimentin proteins. Conclusion: The anatomical and the immunohistochemical features of the ectopic organoid structures identified in fetal female reproductive tract suggest that endometriotic as well as neoplastic disease in adult women may develop on the basis of misplaced endometrial glands and/or embryonic cell remnants.

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Endometriosis and Genital Anomalies:Some Histogenetic Aspects of External Endometriosis

Cited by 21 publications

References 15 publications

Embryologic origin of endometriosis: Analysis of 101 human female fetuses

Embryologic origin of endometriosis: Analysis of 101 human female fetuses

Endometriosis: A Disease That Remains Enigmatic

Identification of Displaced Endometrial Glands and Embryonic Duct Remnants in Female Fetal Reproductive Tract: Possible Pathogenetic Role in Endometriotic and Pelvic Neoplastic Processes

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