Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):484-5. Epub 2011 Oct 11.

Coexisting peritoneal tuberculosis and endometriosis masquerading as advanced stage ovarian cancer in a postpartum woman: a case report and review of literature.

Zhou S, Zhang B, Huang F, Liu J, Zhu D, Zhao X.

 

Clin Exp Obstet Gynecol. 2011;38(3):294-6.

Gossypiboma: a rare abdominal lesion of women after cesarean section, usually misdiagnosed as a neoplasm.

Mavrigiannaki PE, Dastamani C, Vouza E, Lambropoulou E, Kairi-Vassilatou E, Kondi-Pafiti A.

Source

Department of Pathology, Aretaieon Hospital, University of Athens, Athens, Greece.

Abstract

The case of a 20-year-old pregnant woman with a history of one previous cesarean section (CS) who developed a tumorous mass in the area of the CS scar is presented. The clinical diagnosis of endometriosis or fibromatosis was made but the histologic findings were confusing and the pathological diagnosis of an inflammatory type of liposarcoma was made. The case was referred to our Laboratory for re-evaluation and the diagnosis of gossypiboma was made based on histopathological features, the patient’s age, her medical history and the exact location of the lesion. Gossypiboma is a foreign body-related inflammatory pseudotumor caused by retained non-resorbable or even resorbable substances, such as glue, surgical gause or sutures. It is an obscure lesion ignored by doctors of all specialties studying the differential diagnosis of a postoperative mass.

Clin Exp Obstet Gynecol. 2011;38(3):288-90.

Abdominal wall endometriosis following cesarean section: report of five cases.

Demir B, Senerbahce Z, Guzel AI, Demir S, Kilinc N.

Source

Department of Obstetrics and Gynecology, Ergani State Hospital, Diyarbakir, Turkey. bulentdemirmd@hotmail.com

Abstract

BACKGROUND:

Endometriosis is the presence of endometrial tissue outside the uterus. Abdominal wall endometriosis is a very rare location of this pathology. We aimed to report a series of five cases of abdominal wall endometriosis following cesarean section at our clinic.

CASE REPORT:

All of our cases had had previous cesareans section and complained of pain at the pfannensteil incision scar. The cases presented palpable and tender masses near the scar. After excision of the masses histopathology reported the masses as endometriosis.

CONCLUSION:

Abdominal wall endometriosis is a rare condition. Clinicians should be aware of this pathology especially in women presenting with a painful mass near the scar of a previous cesarean section.

Duodecim. 2011;127(17):1837-47.

Current treatment of endometriosis.

[Article in Finnish]

Härkki P, Heikkinen AM, Setälä M.

Source

HYKS:n naistenklinikka, PL 140, 00029 HUS.

Abstract

Early diagnosis of endometriosis is important for proper planning of the treatment. First-line treatment of moderate endometriosis is hormonal drug therapy, which should be long-standing. Surgery is needed, if pain symptoms cannot be controlled with medication. For patients with severe endometriosis, surgical treatment is often the first-line therapy. Complete elimination of the foci of endometriosis is attempted already at the first time. More than half of endometriosis patients will get pregnant and give birth to a child either naturally or via infertility treatments.

Duodecim. 2011;127(17):1827-35.

Pathogenesis of endometriosis.

[Article in Finnish]

Huhtinen K, Perheentupa A, Poutanen M, Heikinheimo O.

Source

Turun yliopisto, biolääketieteen laitos, fysiologia ja TYKS:n naistenklinikka, Kiinamyllynkatu 10, 20014 Turun yliopisto.

Abstract

Of women of reproductive age, 6 to 10% are estimated to be affected by endometriosis. Growth of tissue resembling the uterine mucosa outside the uterine cavity often causes severe menstrual pain, chronic pelvic pain and infertility for the patients. No permanent cure is known for endometriosis, and in fact it often recurs. There are several theories of the pathogenetic mechanisms of the disease, and it is possible that different types of foci may originate in various ways.

Int J Oncol. 2012 Feb;40(2):350-6. doi: 10.3892/ijo.2011.1226. Epub 2011 Oct 6.

Narrow band imaging in gynecology: a new diagnostic approach with improved visual identification (Review).

Kisu I, Banno K, Tsuji K, Masuda K, Ueki A, Kobayashi Y, Yamagami W, Susumu N, Aoki D.

Source

Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.

Abstract

Narrow band imaging (NBI) is a new endoscopic technique in which images of mucosal microstructures and capillary structures are enhanced by shifting the light spectrum to a narrow band. Image-enhanced gastrointestinal endoscopy using NBI has improved the qualitative diagnosis of the grade and depth of invasion of an atypical lesion. NBI is currently not commonly used in gynecological endoscopy, but has recently been applied in laparoscopy and hysteroscopy. The utility of NBI for diagnosis of endometrial lesions and endometriosis has also been shown. In gynecological endoscopy, NBI provides enhanced images of mucosal microstructures and capillary structures and improves visual identification of lesions. Therefore, image-enhanced observation using NBI is likely to be useful for improved detection of lesions in endoscopic diagnosis. However, this technique remains experimental so far, and no study has demonstrated improved clinical outcome using this technique. In this review, we discuss the utility and potential applications of NBI in clinical practice in gynecology.

Am J Surg Pathol. 2011 Dec;35(12):1837-47.

PAX2 and PAX8 expression in primary and metastatic müllerian epithelial tumors: a comprehensive comparison.

Ozcan A, Liles N, Coffey D, Shen SS, Truong LD.

Source

Department of Pathology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey. aozcan06018@gmail.com

Abstract

PAX2 and PAX8 are transcription factors that are essential in embryonic development of müllerian organs. They may also play a role in tumor development in these organs. The diagnostic utility of PAX2 and PAX8 relative to one another has not been comprehensively studied. Archival tissue samples for normal or non-neoplastic tissue (251), primary epithelial neoplasms (316 for PAX2 and 357 for PAX8), and metastatic epithelial neoplasms (16), all of müllerian origin, were subjected to PAX2 and PAX8 immunostaining. The staining frequency, extent, and intensity for these markers were compared. Virtually identical PAX2 and PAX8 expressions were noted in non-neoplastic tissue. They were constantly seen in most epithelial cells (but not in stromal cells) of the endocervix, endometrium, fallopian tube, paratubal cyst, endosalpingiosis, endometriosis, and endometrial polyp. Within the primary epithelial neoplasms, PAX2 and PAX8 expression was noted in 55% and 98% of serous tumors, 25% and 94% of endometrioid tumors, 19% and 100% of clear cell tumors, 11% and 67% of transitional/undifferentiated tumors, and 10% and 22% of mucinous tumors, respectively. Regardless of histologic subtypes, PAX2 staining was noted in fewer cells and with less staining intensity compared with PAX8. No tumor showed only PAX2 staining. Within the metastatic carcinomas, PAX2 and PAX8 expression was noted in 38% and 98% of cases, respectively, with a diffuse and strong staining for PAX8, contrasting with a patchy and weak PAX2 expression. PAX2 and PAX8 are constantly expressed in normal or non-neoplastic tissue of müllerian origin. For primary and metastatic müllerian epithelial tumors, PAX8 shows strong and diffuse staining in most cases of all histologic subtypes, except in mucinous tumors. In contrast, PAX2 expression is always less than PAX8, and exclusive staining for PAX2 is not seen. PAX8 supersedes PAX2 as probably the best epithelial marker hitherto for primary or metastatic müllerian epithelial tumors.

Mol Hum Reprod. 2011 Oct 11. [Epub ahead of print]

MiR-199a attenuates endometrial stromal cell invasiveness through suppression of the IKK{beta}/NF-kB pathway and reduced interleukin-8 expression.

Dai L, Gu L, Di W.

Source

Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.

Abstract

MicroRNAs have recently been identified as regulators that modulate target gene expression and are suggested to be involved in the development and progression of the endometriosis. This study was undertaken to analyze the expression level of miR-199a in paired ovarian endometrioma and eutopic endometrium from women with endometriosis, and to investigate the contribution of microRNA-199a (miR-199a) to the invasive capability of endometrial stromal cells (ESC). Cell adhesion, migration and Matrigel invasion assays were carried out to measure the invasiveness of ESCs. Bioinformatics prediction, reporter gene assay, PCR, Western blotting and ELISA were performed to identify miR-199a targets and related signaling pathways. The results showed that the expression level of miR-199a was lower in the eutopic endometrium from women with endometriosis, and even lower in the paired ovarian endometrioma, compared with the expression in normal controls. Moreover, ectopic expression of miR-199a attenuated ESC adhesion, migration and invasiveness. MiR-199a targeted and inhibited IkappaB kinase beta (IKKβ) in ESCs. Accompanied by IKKβ reduction, miR-199a suppressed nuclear factor-kappa B (NF-κB) pathway activation and interleukin-8 (IL-8) production in ESCs. All these findings suggest that miR-199a, down-regulated in endometriosis, attenuates the invasive capability of ESCs in vitro partly through IKK/NF-κB pathway suppression and reduced IL-8 expression. In conclusion, miR-199a could be involved in the pathogenesis of endometriosis.

Diagn Cytopathol. 2011 Oct 11. doi: 10.1002/dc.21779. [Epub ahead of print]

Fine-needle aspiration cytology of abdominal wall endometriosis: A Study of 10 Cases.

Kim JY, Kwon JE, Kim HJ, Park K.

Source

Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea. jykimpath@paik.ac.kr.

Abstract

While about 15% of menstruating women develop endometriosis, abdominal wall endometriosis is relatively rare. We present 10 cases of abdominal wall endometriosis diagnosed by fine-needle aspiration (FNA) cytology and confirmed by subsequent surgical excision. A palpable abdominal wall mass was the most common symptom, followed by pain. Nine cases were associated with previous surgery. The smear showed glandular epithelial cells and spindle or ovoid stromal cells accompanied by macrophages in eight cases. The nucleus was round-to-oval and the nucleolus was inconspicuous. Mitosis was not observed in any case. In two cases, which were suspicious of malignancy on FNA, the epithelial cells showed anisonucleosis, hyperchromasia, and small conspicuous nucleoli. The stromal cells were spindle or ovoid in shape, without metaplastic changes. Histiocytes were noted in nine cases and hemosiderin-laden histiocytes were noted in two cases. The proportion of inflammatory cells varied. FNA diagnosis of abdominal wall endometriosis is possible when the cytological features are interpreted cautiously, together with the patient’s clinical history. An accurate diagnosis on FNA will prevent unnecessary surgery.

Iran Biomed J. 2011 Jul;15(3):66-72.

Semi-quantitative analysis of HOXA11, leukemia inhibitory factor and basic transcriptional element binding protein 1 mRNA expression in the mid-secretory endometrium of patients with endometriosis.

Alizadeh Z, Shokrzadeh N, Saidijam M, Sanoee MF.

Source

Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. alizadeh@umsha.ac.ir

Abstract

BACKGROUND:

HOXA11 and leukemia inhibitory factor (LIF) and basic transcriptional element binding protein1 (BTEB1) are expressed in endometrium throughout the menstrual cycle and show a dramatic increase during the mid-luteal phase at the time of implantation. In this case-control study, the expression pattern of these mRNA was evaluated in patients with endometriosis at the time of implantation. We also describe a semi-quantitative RT-PCR protocol optimized in our laboratory.

METHODS:

Eight patients with endometriosis were considered as our case and 8 fertile women as control group. Expression levels of HOXA11, LIF and BTEB1 mRNA were measured in endometrium during the mid-secretory phase using semi-quantitative RT-PCR.

RESULTS:

We describe the detailed procedure for the analysis of HOXA11, LIF and BTEB1 mRNA levels. Endometrial HOXA11 and LIF mRNA expression levels (normalized to beta-actin expression) were significantly decreased in endometrium of infertile patients with endometriosis compared with healthy fertile controls at the time of implantation (P < 0.05). A similar trend was seen in BTEB1 mRNA expression.

CONCLUSION:

The results suggest that the alteration in expression pattern of the some genes could account for some aspects of infertility in endometriosis.

J Int Med Res. 2011;39(4):1184-92.

New serum biomarkers for detection of endometriosis using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Zheng N, Pan C, Liu W.

Source

Department of Gynaecology and Obstetrics, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Abstract

This study used proteomic fingerprint technology, combining nano-sized magnetic beads with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS), to screen for potential protein biomarkers for the diagnosis of endometriosis. Serum proteins from 126 patients with endometriosis and 120 healthy controls were profiled and compared. Biomarker pattern software identified 46 discriminating mass-to-charge m/z ratio peaks that were related to endometriosis. The model constructed by the software, based on three of these peaks (m/z 5988.7, 7185.3 and 8929.8), generated excellent separation between the endometriosis and control groups. The sensitivity was 91.4% and the specificity 95.0%. Blind testing on a second series of serum samples from patients with endometriosis and healthy controls indicated a sensitivity of 89.3% and a specificity of 90.0%. Biomarkers for endometriosis can be discovered in serum by MALDI-TOF-MS in combination with nano-sized magnetic beads. The pattern of combined markers provides a powerful and reliable diagnostic method for endometriosis, with high sensitivity and specificity.

Gynecol Obstet Invest. 2011;72(3):145-51. Epub 2011 Oct 7.

Effects of dienogest on surgically induced endometriosis in rats after repeated oral administration.

Fischer OM, Kaufmann-Reiche U, Moeller C, Fuhrmann U.

Source

Bayer Healthcare Pharmaceuticals AG, Global Drug Discovery, TRG Women’s Healthcare, Müllerstrasse 178, Berlin, Germany. oliver-martin.fischer@bayer.com

Abstract

BACKGROUND:

Dienogest demonstrates efficacy for lesion reduction and pain relief in clinical trials of endometriosis. The current study investigated an intraperitoneal animal model of endometriosis to further characterize the effects of dienogest.

METHODS:

Endometrial-like lesions were induced in rats by autotransplantation of uterine tissue into the peritoneal cavity. Dienogest 0.3 or 1.0 mg/kg/day, danazol 100 mg/kg/day, or vehicle control were administered orally for 28 days. Changes in endometrial-like lesion size during treatment were assessed at laparotomy. Uterine horn weight was also measured as an index of the estrogenic effects of treatment.

RESULTS:

Dienogest 0.3 mg/kg/day significantly reduced the total endometrial lesion area, with an effect equivalent to danazol 100 mg/kg/day. Unlike dienogest 1.0 mg/kg/day, dienogest 0.3 mg/kg/day had no effect on uterine horn weight, indicating an absence of estrogenic effects for this dose in rodents.

CONCLUSION:

Dienogest 0.3 mg/kg/day for 28 days demonstrated potent inhibitory activity on the growth of endometrial tissue in this model, providing supportive evidence for the efficacy of dienogest in lesion reduction.

JSLS. 2011 Jul-Sep;15(3):396-9.

Robotic-assisted laparoscopic management of ureteral endometriosis.

Frick AC, Barakat EE, Stein RJ, Mora M, Falcone T.

Source

Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.

Abstract

Endometriosis is the leading cause of female pelvic pain and infertility and affects approximately 10% of women. Lesions involve the urinary tract in up to 6% of cases with ureteral involvement in a smaller subset of .08% to 1%. Multiple authors describe open and laparoscopic approaches to management of ureteral endometriosis; however, this report describes 2 cases of ureteral obstruction secondary to endometriosis managed with robotic-assisted laparoscopic partial ureterectomy and ureteroneocystostomy.

JSLS. 2011 Jul-Sep;15(3):387-92.

Robotic-assisted laparoscopic treatment of bowel, bladder, and ureteral endometriosis.

Nezhat C, Hajhosseini B, King LP.

Source

Department of Obstetrics, Gynecology and Surgery, Stanford University, USA. cnezhat@stanford.edu

Abstract

BACKGROUND:

Endometriosis commonly affects the pelvic organs but can also affect organs outside the pelvis and is then termed extragenital endometriosis.

CASES:

Successful robotically assisted laparoscopic management of extragenital endometriosis, specifically, endometriosis of the bowel, bladder, and ureter in 5 patients.

CONCLUSION:

A substantial body of evidence supports the laparoscopic approach as the preferred method for many procedures; yet, a majority of procedures today still are performed by laparotomy. This preference for open procedures is likely due to the lack of trained endoscopic surgeons, the difficulty in obtaining proper instruments, and the long learning curve of operative laparoscopy. The recent advent of computer-enhanced technology may provide the bridge necessary for more surgeons to incorporate laparoscopic surgery in the treatment of complex cases.

JSLS. 2011 Jul-Sep;15(3):343-5.

Indication for laparoscopically assisted vaginal hysterectomy.

Shiota M, Kotani Y, Umemoto M, Tobiume T, Hoshiai H.

Source

Department of Obstetrics and Gynecology, Kinki University School of Medicine, Japan. shiota@med.kindai.ac.jp

Abstract

OBJECTIVES:

Total hysterectomy procedures include total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), and laparoscopically assisted vaginal hysterectomy (LAVH). Our institution has introduced LAVH as a preferred option to the more invasive TAH. To date, no reports have proposed surgical indications for LAVH based on statistical analysis of surgical results. The purpose of this study was to establish criteria for performing LAVH through statistical analysis of a retrospective review of surgical outcomes in LAVH cases at our institution over a period of 15 years.

METHODS:

The medical records of 629 patients scheduled for LAVH for uterine fibroids and/or adenomyosis at our hospital were examined. Surgical results (blood loss, operative time, rates of conversion to laparotomy, and intraand postoperative complications) were compared among 9 groups classified by uterine weight.

RESULTS:

Statistically significant differences in surgical outcomes were found between the group with a uterine weight ≥ 800g and the other groups.

CONCLUSION:

We found that when the uterine weight was ≥ 800g, TAH was more appropriate because significant blood loss and/or complications would be expected during LAVH. A removed uterus weighing 800g is reportedly equivalent to a preoperative uterine size of approximately 12 cm. Therefore, LAVH may be safely indicated for patients with a uterine size ≤ 12 cm (approximately equivalent to the uterine size at 16-weeks gestation).

JSLS. 2011 Jul-Sep;15(3):331-8.

Comparison of laparoscopic anterior discoid resection and laparoscopic low anterior resection of deep infiltrating rectosigmoid endometriosis.

Moawad NS, Guido R, Ramanathan R, Mansuria S, Lee T.

Source

Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania, USA. nmoawad@ufl.edu

Abstract

OBJECTIVE:

To compare laparoscopic anterior discoid resection (ADR) with low anterior resection (LAR).

METHODS:

This is a retrospective review of a cohort (Canadian Task Force classification II-2) of patients undergoing laparoscopic ADR or LAR at a university hospital. Chart review and telephone questionnaires were conducted to examine long-term outcomes. Preoperative and operative findings, short- and long-term outcomes were compared. SF-12 quality of life scores, need for further interventions, and overall satisfaction were also compared.

RESULTS:

Twenty-two patients underwent laparoscopic ADR (n 8) or LAR (n 14) for rectosigmoid endometriosis between January 2001 and December 2009. Mean follow-up time was 41.26 months (range, 14 to 70). Patients undergoing laparoscopic ADR had significantly less blood loss and shorter operative time and hospital stay. Patients who required LAR had a significantly higher rate of mucosal involvement (61.5% v. 0%). No statistically significant difference was found in the size, depth of invasion, location of lesions, or operative complications. Fifty percent of the LAR group had several lesions as opposed to 12.5% of the ADR group. Median age was significantly higher in patients who required LAR (39) than in patients who required ADR (32). Three patients in the LAR group (21.4%) had anastomotic strictures; 2 required dilation. The ADR group had consistently higher increments of improvement in bowel symptoms and dyspareunia. Overall satisfaction rate with the procedures was 93.3%. SF-12 scores were comparable between the 2 groups.

CONCLUSION:

ADR compared with LAR is associated with decreased operative time, blood loss, and hospital stay and a lower rate of anastomotic strictures. Other outcomes and satisfaction rates are comparable between the 2 procedures.

J Pathol. 2011 Nov;225(3):390-400. doi: 10.1002/path.2963. Epub 2011 Aug 24.

Hypoxia-inhibited dual-specificity phosphatase-2 expression in endometriotic cells regulates cyclooxygenase-2 expression.

Wu MH, Lin SC, Hsiao KY, Tsai SJ.

Source

Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.

Abstract

Endometriosis is one of the most common gynaecological diseases that significantly reduces the life qualify of affected women and their families. Aberrant expression of cyclooxygenase-2 (COX-2), and thus over-production of prostaglandin E(2) (PGE(2) ) has been shown to play critical roles in the development of this disease. However, the mechanism responsible for COX-2 over-expression remains obscure. Here, we provide evidence for what we believe is a novel mechanism in regulating COX-2 expression in endometriotic stromal cells. Dual-specificity phosphatase-2 (DUSP2), a nuclear phosphatase that inactivates mitogen-activated protein kinase (MAPK), is markedly down-regulated in stromal cells of ectopic endometriotic tissues, which results in prolonged activation of extracellular signal-regulated kinase (ERK) and p38 MAPK and increased COX-2 expression. Expression of DUSP2 is inhibited by hypoxia inducible factor-1α (HIF-1α) at the transcriptional level. Treatment of normal endometrial stromal cells with hypoxia, or chemicals that cause HIF-1α accumulation, results in DUSP2 down-regulation, prolonged ERK phosphorylation and COX-2 over-expression. In contrast, forced expression of DUSP2 under hypoxia abolishes HIF-1α-induced ERK phosphorylation and COX-2 expression. Furthermore, suppression of DUSP2 by HIF-1α in eutopic endometrial stromal cells increases sensitivity of cox-2 gene to interleukin-1β stimulation, a phenomenon resembling endometriotic stromal cell characteristics. Taken together, these data suggest that DUSP2 is an important molecule in endometrial physiology and that hypoxia-inhibited DUSP2 expression is a critical factor for the development of endometriosis.

Mod Pathol. 2012 Jan;25(1):122-30. doi: 10.1038/modpathol.2011.143. Epub 2011 Oct 7.

Accumulative copy number increase of MET drives tumor development and histological progression in a subset of ovarian clear-cell adenocarcinomas.

Yamamoto S, Tsuda H, Miyai K, Takano M, Tamai S, Matsubara O.

Source

Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan.

Abstract

Our previous study demonstrated that, among ovarian carcinomas, amplification of the MET gene and overexpression of MET specifically and commonly occur in clear-cell adenocarcinoma histology. This study was conducted to address how these alterations contribute to development and progression of this highly chemoresistant form of ovarian cancer. We histologically reviewed 21 previously described MET amplification-positive clear-cell adenocarcinoma cases, and selected 11 tumors with synchronous endometriosis and 2 tumors with adjacent clear-cell adenofibroma (CCAF) components. Using double in situ hybridization and immunohistochemistry, copy number alterations of the MET gene and levels of MET protein expression were analyzed in these putative precursor lesions and the corresponding invasive carcinoma components in this selected cohort. All of the non-atypical precursor lesions analyzed (ie, non-atypical endometrioses and the benign CCAFs) were negative for MET gain. However, low-level (≥3 MET copies in ≥10% and ≥4 MET copies in 10-40% of tumor cells) gain of MET was detected in 4 (40%) of the 10 atypical endometrioses and 1 of the 2 borderline CCAFs. Moreover, high-level (≥4 MET copies in ≥40% of tumor cells) gain of MET were detected in five (50%) of the atypical endometrioses. In 4 (31%) of the 13 cases enrolled, intratumoral heterogeneity for MET gain was documented in invasive carcinoma components, wherein all the relatively differentiated carcinoma components showed low-level gain of MET and all the corresponding poorly differentiated carcinomas showed high-level gain. The overall incidence of MET overexpression gradually increased from the precursors of non-atypical form (0%), through those of atypical form (67%) and the relatively differentiated carcinoma components (92%), to the poorly differentiated carcinoma components (100%). These results suggest that accumulative MET gene copy number alterations causing MET overexpression are associated with higher tumor grade and might drive the development and progression of the MET amplification-positive ovarian clear-cell adenocarcinoma.

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2011 Oct;28(5):555-8.

Association of the IL-6 gene 634C/G polymorphism with susceptibility to endometriosis.

[Article in Chinese]

Mao T, Zong LL, Wang YF, Zhao X, Fu YG, Zeng J, Rao XQ.

Source

Department of Gynecology and Obstetrics, Southern Medical University, Guangdong, People’s Republic of China.

Abstract

OBJECTIVE:

To investigate the association of interleukin 6 gene (IL-6) promoter region 634C/G (rs1800796) single nucleotide polymorphism (SNP) with the genetic susceptibility to endometriosis (Ems) in south Han Chinese women.

METHODS:

A case-control study was performed in 432 Ems patients and 499 control women to evaluate the SNP of IL-6 634C/G by using a fluorescent quantitative PCR-based high resolution melting (HRM) method.

RESULTS:

There were statistical significances in the IL-6 634C/G alleles, whether or not to carry allele G and genotype distributions between Ems patients and control women (P=0.032, 0.014 and 0.045, respectively). Allele C enhanced the risk of Ems 1.057 times while allele G reduced the risk of Ems 0.835 time. Carrying allele G reduced the risk of Ems 0.822 time, whereas not carrying allele G enhanced the risk of Ems 1.143 times. Compared with genotype CC, the risk of Ems with genotype CG reduced 0.704 time (95% CI: 0.533-0.931). There was no significant difference in whether or not carrying allele G distribution between Ems patients and control women (P=0.729).

CONCLUSION:

The present study demonstrated significant association between the SNP of IL-6 634C/G and genetic susceptibility to Ems in south Han Chinese women.

Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):482-3. Epub 2011 Oct 5.

Endometriosis: a crosstalk between epidermal growth factor (EGF) gene polymorphism and telomerase activity?

Mormile R, Vittori G.

 

Srp Arh Celok Lek. 2011 Jul-Aug;139(7-8):531-5.

Diagnosis and treatment of deep infiltrating endometriosis with bowel involvement: a case report.

Sparić R, Hudelist G, Keckstein J.

Source

Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Visegradska 26, 11000 Belgrade, Serbia. radmila@rcub.bg.ac.rs

Abstract

INTRODUCTION:

Deep infiltrating endometriosis is a form of endometriosis penetrating deeply under the peritoneal surface causing pain and infertility. Assessment of the pelvis by laparoscopy and histological confirmation of the disease is considered the golden standard of diagnosis.

CASE OUTLINE:

We are presenting a patient diagnosed with deep infiltrating endometriosis by transvaginal ultrasound and treated with minimally invasive radical surgery including segmental resection of the bowel.

CONCLUSION:

Transvaginal sonography has an important role in detecting deep endometriosis of the pelvis. Fertility sparing surgery is the treatment of choice in symptomatic women wishing to retain fertility, since drugs used for endometriosis interfere with ovulation.The success of the surgery depends on the accuracy of the preoperative diagnosis. A multidisciplinary approach in managing deep endometriosis is mandatory in order to offer patients the best possible treatment using the combined skills of the colorectal and gynaecologic surgical teams. The presented case exhibits the feasibility of laparoscopic approach to severe pelvic endometriosis with bowel involvement.

Int J Gynecol Pathol. 2011 Nov;30(6):553-68.

Endometriosis and ovarian cancer: a review of clinical, pathologic, and molecular aspects.

Wei JJ, William J, Bulun S.

Source

Department of Pathology, Division of Reproductive Biology Research, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Chicago, IL, 60611, USA. jianjun-wei@northwestern.edu

Abstract

Endometriosis is a chronic disease that affects millions of reproductive-age women. Despite the destructive and invasive nature of endometrioses, most cases are perpetually benign or eventually regress; however, atypical endometriosis is a precursor lesion and can lead to certain types of ovarian cancer. Endometriosis induced inflammation and auto- and paracrine production of sex steroid hormones contribute to ovarian tumorigenesis. These changes provide microenvironment necessary to accumulate enough genetic alterations for endometriosis associated malignant transformation. It takes years for endometriosis to undergo the pathophysiological progression that begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), and then is followed by the formation of well-defined borderline tumors, and finally culminates in fully malignant ovarian cancer. This study is a review of the natural history of endometriosis and the role of microenvironments that favor the accumulation of genetic alterations and endometriosis-associated ovarian cancer progression.

Int J Gynaecol Obstet. 2011 Dec;115(3):293-4. Epub 2011 Oct 5.

Prevalence, characteristics, and management of endometriosis in an infertile Maltese population.

Camilleri L, Schembri A, Inglott AS.

Source

Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta. loreta1511@gmail.com

J Reprod Immunol. 2011 Dec;92(1-2):74-81. Epub 2011 Oct 5.

Dysregulation of the Fas/FasL system in mononuclear cells recovered from peritoneal fluid of women with endometriosis.

Sturlese E, Salmeri FM, Retto G, Pizzo A, De Dominici R, Ardita FV, Borrielli I, Licata N, Laganà AS, Sofo V.

Source

Department of Gynecological Sciences, School of Medicine, Policlinico Universitario G. Martino, Via C. Valeria -Gazzi-, University of Messina, 98125 Messina, Italy. esturlese@unime.it

Abstract

In endometriosis, regurgitating endometrial cells fail to undergo apoptosis and implant themselves outside the uterus, particularly in the peritoneum. We studied Fas and FasL behaviour by evaluating the percentages of mFas and mFasL-bearing mononuclear cells from peritoneal fluid, the level of Fas and FasL gene expression at both mRNA and protein levels in the same cells, and the sFas and sFasL values in peritoneal fluid of 80 endometriotic women, at four stages of disease severity. We found no variation in percentage of mFas-bearing mononuclear cells; high and unchanging levels of Fas mRNA and protein, and high and invariable sFas values. Overproduction of sFas antagonises mFas function and plays a role as a decoy in the peritoneal fluid. The mFasL-bearing mononuclear cells and protein levels decreased from the minimal to the severe stage of disease. In contrast to FasL protein, FasL mRNA was overexpressed throughout the course of the disease. sFasL values were high and increased as the disease worsened. Our results showed a non-linear ratio between FasL mRNA and FasL protein levels. Abnormally elevated FasL mRNA may be due to dysregulation in several mechanisms controlling mRNA turnover. The high level of sFasL would be expected to down-regulate FasL activity and compete with the membrane form for mFas binding. As a consequence, mFas-bearing mononuclear cells may be unable to kill and in turn, may themselves become targets for killing by FasL-expressing endometriotic cells.

J Cutan Aesthet Surg. 2011 May;4(2):141-3.

Massive abdominal wall endometriosis masquerading as desmoid tumour.

Anand M, Deshmukh SD.

Source

Department of Pathology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, India.

Abstract

Endometriosis is a common gynaecological condition that usually presents as an abdominal lump. It can be a diagnostic dilemma and should be considered as a differential diagnosis for lumps in the abdomen in females. We discuss a case of abdominal wall endometriosis following caesarean section, which was misdiagnosed as a desmoid tumour.

Bioconjug Chem. 2011 Nov 16;22(11):2304-16. Epub 2011 Oct 5.

Synthesis and biological evaluation of water-soluble progesterone-conjugated probes for magnetic resonance imaging of hormone related cancers.

Sukerkar PA, MacRenaris KW, Townsend TR, Ahmed RA, Burdette JE, Meade TJ.

Source

Department of Chemistry, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, USA.

Abstract

Progesterone receptor (PR) is strongly associated with disease prognosis and therapeutic efficacy in hormone-related diseases such as endometriosis and breast, ovarian, and uterine cancers. Receptor status is currently determined by immunohistochemistry assays. However, noninvasive PR imaging agents could improve disease detection and help elucidate pathological molecular pathways, leading to new therapies and animal disease models. A series of water-soluble PR-targeted magnetic resonance imaging (MRI) probes were synthesized using Cu(I)-catalyzed click chemistry and evaluated in vitro and in vivo. These agents demonstrated activation of PR in vitro and preferential accumulation in PR(+) compared to PR(-) human breast cancer cells with low toxicity. In xenograft tumor models, the agents demonstrated enhanced signal intensity in PR(+) tumors compared to PR(-) tumors. The results suggest that these agents may be promising MRI probes for PR(+) diseases.

Niger J Med. 2011 Apr-Jun;20(2):191-9.

Endometriosis.

Okeke TC, Ikeako LC, Ezenyeaku CC.

Source

Department of Obstetrics & Gynaecology University of Nigeria Teaching Hospital, Enugu, Nigeria. Ubabikctochukwu@iyahoo.comendometriosis

Abstract

BACKGROUND:

Endometriosis is a common mysterious and fascinating gynaecological condition with diverse clinical manifestations, highly variable and unpredictable clinical course with decreased quality of life. Despite extensive research, endometriosis is fraught with controversies.

METHODS:

Review of pertinent literature on endometriosis, selected references, internet services through gynaecological search which have been critical in the understanding of this puzzling gynaecologic condition were included in the review.

RESULTS:

Endometriosis most commonly afflict women in there late 20s and 30s. The classic symptom complex include dysmenorrhoea, dyspareunia, menorrhagia and infertility. About 30% of the patients are asymptomatic. The incidence of infertility amongst women suffering from endometriosis ranges from 30%-40%. The factors implicated in causing endometriosis-associated infertility are multiple and its management is shrouded in controversy, complex and imperfectly understood.

CONCLUSION:

Inspite of diverse clinical manifestations, variable and unpredictable clinical course, there is a chance to improve pregnancy rates with improvement in assisted reproductive technology.

J R Soc Med. 2011 Oct;104(10):421-3.

Extraluminal bowel obstruction by endometrioid adenocarcinoma 34 years post-hysterectomy: risks of unopposed oestrogen therapy.

Wang TT, Jabbour RJ, Girling JC, McDonald PJ.

Source

Department of General Surgery, Northwick Park & St Mark’s Hospitals, Harrow, UK. tim.wang04@imperial.ac.uk

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