Renal endometriosis treated with a gonadotrophin releasing hormone agonist. Case report

Abstract

Case reportA healthy woman had first experienced macroscopic haematuria in 1981 at the age of 25. Initially she had intravenous urography, renal angiography and cystoscopy, all with negative findings. Daily haematuria persisted for 3 years and was more pronounced with physical exercise but not with menstruation. She developed diffuse back-pain of increasing severity.In 1984 selective angiography of both kidneys revealed a possible tumour in the left kidney. Ultrasound examination showed a 40 mm cystic tumour at the upper pole of the left kidney. This was punctured and cytological examination revealed fragments of glands with cuboidal epithelium. This epithelium was not of renal origin and, as the puncture was performed retroperitoneally, could not have been obtained from the gastrointestinal tract. Blood cells were present inside the glandular fragments and renal endometriosis was suspected. Because of this and because of the discovery of a pelvic tumour, 15mm in diameter, she was referred to the Department of Obstetric and Gynaecology. At laparotomy an endometriotic cyst was removed from her left ovary. No endometriosis was observed elsewhere in the pelvis or abdomen.She was treated with the progestogen lynestrenol 5-15 mg/day for 6 months. The dose was increased until she developed amenorrhoea. Macroscopic haematuria ceased but microscopic References Editorial (1986) LHRH analogues in endometriosis. Rosdy E., Shgi T & Torok P. (1979) Endometnose der Lancet ii, 1016-1018. Niere (English summary). Urologe [A] 18:22-25.

Renal Endometriosis Mimicking Cystic Renal Tumor: Case Report and Literature Review

“…Ultrasound-guided fine needle aspiration (FNA) biopsy is an accurate and minimally invasive method that can greatly help in the diagnosis of endometriosis. To date, three cases of renal endometriosis have been confirmed by FNA ( 45 , 47 , 48 ). Ultrasound is very useful for detecting endometriosis in the uterus and ovary ( 61 ), and most importantly, it is cheap, especially suitable for developing countries.…”

“…Urinary tract involvement is uncommon and primarily manifests in the bladder, followed by the ureters and kidneys, at a ratio of 40:5:1 (41). Marshall first reported renal endometriosis in 1943 (20), and only 16 pathologically confirmed cases have been reported in the past 30 years (Table 2) (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56). The median age was 37 years (range, 23-53 years).…”

“…Asymptomatic patients with multiple small lesions unchanged during subsequent imaging examinations generally do not require any definitive therapy for renal lesions ( 54 ). Hormone therapy, such as GnRH agonists and oral contraceptives, can be used for symptom management ( 45 , 48 , 51 ). Hormonal treatment reduces the pain in the short-term follow up and is the best treatment for patients of reproductive age ( 64 ).…”

Endometriosis in ectopic kidney: A rare case report and literature review

“…Renal endometriosis was rst reported by Marshall in 1943 [4] .It is very rare in the past 30 years, and only 17 cases of renal endometriosis have been reported [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. To our knowledge, this is the rst report of endometriosis within ectopic kidney.…”