Pub Date : 2023-08-25DOI: 10.1177/22840265231189914
S. Bazmi, S. Amer
Endosalpingiosis is an understudied gynaecological condition with limited knowledge of its prevalence and clinical significance. We report two rare cases of severe endosalpingiosis aged 25 and 30 highlighting their clinical, laparoscopic and histological features, as well as treatment outcomes. Both cases presented with severe and intractable chronic pelvic pain (CPP) with a pattern like endometriosis pain. Initially, they received standard medical management for CPP, including hormonal therapy and pain modulators, with limited or no improvement. They were then offered laparoscopy, which revealed widely spread superficial vesicular lesions on ovaries, pelvic peritoneum, uterus and bowel. Wide excision of affected peritoneum was performed, and multiple biopsies were obtained from ovarian lesions. Histology revealed endosalpingiosis in both cases. In case 2, histology also revealed a neuroendocrine tumour, which was likely from a gastrointestinal (GI) primary malignancy. This case was referred to the GI team for further management. In both cases, surgery resulted in 6-month relief of pelvic pain followed by gradual recurrence of severe symptoms. These cases highlight the clinical dilemma of severe endosalpingiosis, which appears to be associated with intractable pain that is resistant to all standard hormonal and surgical treatments. Whether the association with the neuroendocrine tumour in the second case was incidental or a true link remains uncertain. Further research is required to identify effective treatment strategies for ES.
{"title":"Severe endosalpingiosis: Case reports and a literature review","authors":"S. Bazmi, S. Amer","doi":"10.1177/22840265231189914","DOIUrl":"https://doi.org/10.1177/22840265231189914","url":null,"abstract":"Endosalpingiosis is an understudied gynaecological condition with limited knowledge of its prevalence and clinical significance. We report two rare cases of severe endosalpingiosis aged 25 and 30 highlighting their clinical, laparoscopic and histological features, as well as treatment outcomes. Both cases presented with severe and intractable chronic pelvic pain (CPP) with a pattern like endometriosis pain. Initially, they received standard medical management for CPP, including hormonal therapy and pain modulators, with limited or no improvement. They were then offered laparoscopy, which revealed widely spread superficial vesicular lesions on ovaries, pelvic peritoneum, uterus and bowel. Wide excision of affected peritoneum was performed, and multiple biopsies were obtained from ovarian lesions. Histology revealed endosalpingiosis in both cases. In case 2, histology also revealed a neuroendocrine tumour, which was likely from a gastrointestinal (GI) primary malignancy. This case was referred to the GI team for further management. In both cases, surgery resulted in 6-month relief of pelvic pain followed by gradual recurrence of severe symptoms. These cases highlight the clinical dilemma of severe endosalpingiosis, which appears to be associated with intractable pain that is resistant to all standard hormonal and surgical treatments. Whether the association with the neuroendocrine tumour in the second case was incidental or a true link remains uncertain. Further research is required to identify effective treatment strategies for ES.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44732119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-23DOI: 10.1177/22840265231193486
Simon M Scheck, Bryndl E Hohmann-Marriott, Gary Faughnan, C. Henry
Symptom tracking for endometriosis has been validated with clinical benefits, however, there is limited evidence around the use of mobile apps for endometriosis symptom tracking. We performed a survey of people with suspected or confirmed endometriosis in Aotearoa New Zealand to assess mobile app use for symptom tracking including which app is being used, how frequently symptoms are tracked, which features are most important and which features would be desired. We also explored willingness to share symptom data with clinicians and/or researchers. A total of 188 survey responses were included. Mobile apps were used for symptom tracking by 83/188 (44.1%), with only 13 of 188 (6.9%) reporting they would not consider use of an app. Of current app users, 51.5% reported logging symptoms at least weekly. The most frequently desired features included tracking of specific symptoms (such as periods, pain, bowel symptoms, mental health symptoms), other tracking (such as medications and diet) and general app usability. Of those who use or would consider using an app 77.7% reported they would be comfortable sharing data with clinicians, and 76.1% reported they would be comfortable sharing anonymous data with researchers. Almost half of participants reported using an app to track symptoms, and almost all reported they would consider use. Around three in four patients would be willing to share this data with clinicians and researchers, and therefore further focus on the utility of these apps may benefit patients directly, their relationship with healthcare providers and be utilised for further endometriosis research.
{"title":"A survey exploring the use of symptom diary mobile apps for endometriosis","authors":"Simon M Scheck, Bryndl E Hohmann-Marriott, Gary Faughnan, C. Henry","doi":"10.1177/22840265231193486","DOIUrl":"https://doi.org/10.1177/22840265231193486","url":null,"abstract":"Symptom tracking for endometriosis has been validated with clinical benefits, however, there is limited evidence around the use of mobile apps for endometriosis symptom tracking. We performed a survey of people with suspected or confirmed endometriosis in Aotearoa New Zealand to assess mobile app use for symptom tracking including which app is being used, how frequently symptoms are tracked, which features are most important and which features would be desired. We also explored willingness to share symptom data with clinicians and/or researchers. A total of 188 survey responses were included. Mobile apps were used for symptom tracking by 83/188 (44.1%), with only 13 of 188 (6.9%) reporting they would not consider use of an app. Of current app users, 51.5% reported logging symptoms at least weekly. The most frequently desired features included tracking of specific symptoms (such as periods, pain, bowel symptoms, mental health symptoms), other tracking (such as medications and diet) and general app usability. Of those who use or would consider using an app 77.7% reported they would be comfortable sharing data with clinicians, and 76.1% reported they would be comfortable sharing anonymous data with researchers. Almost half of participants reported using an app to track symptoms, and almost all reported they would consider use. Around three in four patients would be willing to share this data with clinicians and researchers, and therefore further focus on the utility of these apps may benefit patients directly, their relationship with healthcare providers and be utilised for further endometriosis research.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49563031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/22840265231179004
Johanna Netzl, B. Gusy, B. Voigt, J. Sehouli, S. Mechsner
Introduction: We aimed at examining the physical symptoms, sexual and mental health of individuals at the time of receiving the diagnosis of endometriosis. Our goal was to gain a better understanding of their needs at this specific time. Methods: Fifty cis women who had received the diagnosis of endometriosis within the last 4 weeks were examined in this cross-sectional study. Participants completed a comprehensive questionnaire and the Childhood Trauma Questionnaire (CTQ). The Diagnostic Interview for Mental Disorders (DIPS) was performed for each subject for the assessment of mental disorders according to DSM-5 criteria and to screen for sexual dysfunctions. Results: Participants were M = 27.02 ± 5.72 years old. More than 90% reported dysmenorrhea (93.9%), one fifth chronic pelvic pain (22.0%) and more than three quarters painful sexual intercourse (84.0%). More than 40% met the criteria of a current mental disorder. 21 participants reported a sexual dysfunction (42.0%) and 21 reported childhood maltreatment (42.9%). A current mental disorder was associated with impaired sexual functioning: Participants with a current mental disorder reported higher pain intensity scores during sexual intercourse and were more likely to report a current sexual dysfunction. Conclusion: Our results highlight the need for earlier diagnoses of endometriosis to prevent the progression of pelvic pain and for integrating mental and sexual health support in endometriosis care from the beginning. A biopsychosocial model of mental health in endometriosis is proposed.
{"title":"Pain symptoms, sexual and mental health at the time of endometriosis diagnosis","authors":"Johanna Netzl, B. Gusy, B. Voigt, J. Sehouli, S. Mechsner","doi":"10.1177/22840265231179004","DOIUrl":"https://doi.org/10.1177/22840265231179004","url":null,"abstract":"Introduction: We aimed at examining the physical symptoms, sexual and mental health of individuals at the time of receiving the diagnosis of endometriosis. Our goal was to gain a better understanding of their needs at this specific time. Methods: Fifty cis women who had received the diagnosis of endometriosis within the last 4 weeks were examined in this cross-sectional study. Participants completed a comprehensive questionnaire and the Childhood Trauma Questionnaire (CTQ). The Diagnostic Interview for Mental Disorders (DIPS) was performed for each subject for the assessment of mental disorders according to DSM-5 criteria and to screen for sexual dysfunctions. Results: Participants were M = 27.02 ± 5.72 years old. More than 90% reported dysmenorrhea (93.9%), one fifth chronic pelvic pain (22.0%) and more than three quarters painful sexual intercourse (84.0%). More than 40% met the criteria of a current mental disorder. 21 participants reported a sexual dysfunction (42.0%) and 21 reported childhood maltreatment (42.9%). A current mental disorder was associated with impaired sexual functioning: Participants with a current mental disorder reported higher pain intensity scores during sexual intercourse and were more likely to report a current sexual dysfunction. Conclusion: Our results highlight the need for earlier diagnoses of endometriosis to prevent the progression of pelvic pain and for integrating mental and sexual health support in endometriosis care from the beginning. A biopsychosocial model of mental health in endometriosis is proposed.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"72 - 81"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47133720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/22840265231180676
Chelsea E Stewart, M. Castellanos, S. P. Nadella, R. Eliason, P. Doehrman, A. Gubbels
Introduction: We aimed to determine the prevalence of pathology confirmed adenomyosis in women with chronic pelvic pain (CPP) who underwent surgical management with total hysterectomy, and to identify associated risk factors and demographic variables. Methods: This is a retrospective cohort study involving 1186 patients treated in a CPP-specialty clinic who underwent surgical management with hysterectomy between January 2010 and December 2021. Results: About 532/1186 (44.9%) of the cohort were diagnosed with adenomyosis on pathology following total hysterectomy. The average age of patients with adenomyosis was older than those without adenomyosis [41 years vs 38 years (p < 0.001)]. There were no statistically significant differences in symptoms of menstrual bleeding, pelvic pain, dysmenorrhea, or dyspareunia. Those with adenomyosis were more likely to be Hispanic (p < 0.001), have a history of pregnancy (p < 0.001), and have chronic cervicitis (p = 0.037). Uterine weight was significantly higher in the group with adenomyosis (p = 0.033) especially when excluding leiomyoma (p = 0.006). Discussion: The prevalence of adenomyosis on surgical pathology in a CPP cohort was higher than that reported for the general population. Uterine weights are higher in adenomyosis, even when controlling for leiomyoma. Classically attributed symptoms of adenomyosis were not useful predictors for the disease.
{"title":"Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort","authors":"Chelsea E Stewart, M. Castellanos, S. P. Nadella, R. Eliason, P. Doehrman, A. Gubbels","doi":"10.1177/22840265231180676","DOIUrl":"https://doi.org/10.1177/22840265231180676","url":null,"abstract":"Introduction: We aimed to determine the prevalence of pathology confirmed adenomyosis in women with chronic pelvic pain (CPP) who underwent surgical management with total hysterectomy, and to identify associated risk factors and demographic variables. Methods: This is a retrospective cohort study involving 1186 patients treated in a CPP-specialty clinic who underwent surgical management with hysterectomy between January 2010 and December 2021. Results: About 532/1186 (44.9%) of the cohort were diagnosed with adenomyosis on pathology following total hysterectomy. The average age of patients with adenomyosis was older than those without adenomyosis [41 years vs 38 years (p < 0.001)]. There were no statistically significant differences in symptoms of menstrual bleeding, pelvic pain, dysmenorrhea, or dyspareunia. Those with adenomyosis were more likely to be Hispanic (p < 0.001), have a history of pregnancy (p < 0.001), and have chronic cervicitis (p = 0.037). Uterine weight was significantly higher in the group with adenomyosis (p = 0.033) especially when excluding leiomyoma (p = 0.006). Discussion: The prevalence of adenomyosis on surgical pathology in a CPP cohort was higher than that reported for the general population. Uterine weights are higher in adenomyosis, even when controlling for leiomyoma. Classically attributed symptoms of adenomyosis were not useful predictors for the disease.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"58 - 63"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42307434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/22840265231178334
Natalie L. Dinsdale, D. Chizen, B. Crespi
Objective: Investigate how women with self-reported endometriosis, polycystic ovary syndrome (PCOS), or no known reproductive disease perform on the Reading the Mind in the Eyes task, a metric of social cognitive empathic abilities, and how these scores are mediated by self-reported pelvic pain, depression levels, and medication use. Design: Cross-sectional. Setting: Online survey. Population: Saskatchewan; mixed ethnicities. Methods: Participants (n = 342) completed surveys on diagnoses of endometriosis and PCOS, levels of pelvic pain, medications, depression, and cognitive empathy (the Reading the Mind in the Eyes task, RMET). Results: Women with endometriosis showed lower scores on the RMET, compared to unaffected women and women with PCOS. However, among women with endometriosis, higher levels of pelvic pain and higher scores on an index of depression were associated with enhanced RMET performance. Among women with PCOS, medication with spironolactone, an androgen receptor antagonist, was associated with higher RMET scores, compared to women with PCOS who were not medicated or who were taking different medications. Conclusions: Symptoms (including pelvic pain), hormonal correlates, and some treatments of PCOS and endometriosis mediated variation in cognitive empathy.
{"title":"Diagnosis, pelvic pain, and medication mediate cognitive empathic abilities among women with endometriosis or polycystic ovary syndrome","authors":"Natalie L. Dinsdale, D. Chizen, B. Crespi","doi":"10.1177/22840265231178334","DOIUrl":"https://doi.org/10.1177/22840265231178334","url":null,"abstract":"Objective: Investigate how women with self-reported endometriosis, polycystic ovary syndrome (PCOS), or no known reproductive disease perform on the Reading the Mind in the Eyes task, a metric of social cognitive empathic abilities, and how these scores are mediated by self-reported pelvic pain, depression levels, and medication use. Design: Cross-sectional. Setting: Online survey. Population: Saskatchewan; mixed ethnicities. Methods: Participants (n = 342) completed surveys on diagnoses of endometriosis and PCOS, levels of pelvic pain, medications, depression, and cognitive empathy (the Reading the Mind in the Eyes task, RMET). Results: Women with endometriosis showed lower scores on the RMET, compared to unaffected women and women with PCOS. However, among women with endometriosis, higher levels of pelvic pain and higher scores on an index of depression were associated with enhanced RMET performance. Among women with PCOS, medication with spironolactone, an androgen receptor antagonist, was associated with higher RMET scores, compared to women with PCOS who were not medicated or who were taking different medications. Conclusions: Symptoms (including pelvic pain), hormonal correlates, and some treatments of PCOS and endometriosis mediated variation in cognitive empathy.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"64 - 71"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46727034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/22840265231181265
M. Ciebiera, M. Abramiuk, P. Bartnik, S. Feduniw, J. Kacperczyk-Bartnik, M. Włodarczyk, Natalia Żeber-Lubecka
We would like to announce a new vision of the Journal of Endometriosis and Pelvic Pain Disorders. Thanks to the contribution by former Editors-in-Chief, Associate Editors, and Editorial Board members, as well as all Readers we have a stable base and our journal is still growing. Today, it is safe to say that the journal has already matured and that it has a specific goal, specific groups of authors and readers—each of them is unique. The audience of our magazine mostly includes clinicians and scientists dealing with the subject of broadly understood gynecology with an emphasis on minimally-invasive gynecology, as well as the issues of pathophysiology, particularly comprising the topic of endometriosis, pelvic pain, reproduction, uterine fibroids, or some parts of endocrinology or gynecological oncology. Currently, our journal publishes a high quality peer-reviewed basic and clinical original research articles and critical reviews focusing specifically on the diagnosis, medical, and surgical treatment of endometriosis, adenomyosis, and associated disorders in all their multidimensional aspects. In our strategy for the forthcoming years, we will especially keep place for the most important current problems, controversial or unresolved topics in particular, which are not lacking in case of such a poorly understood pathology as endometriosis, pelvic pain, or uterine fibroids. To sum up, we believe that our journal will surely continue developing in all most important areas of clinical and scientific publishing—these mean standards, basic research, translational medicine, and clinical concept.
{"title":"Hot topics and fresh look on old problems: A new vision of the Journal of Endometriosis and Pelvic Pain Disorders","authors":"M. Ciebiera, M. Abramiuk, P. Bartnik, S. Feduniw, J. Kacperczyk-Bartnik, M. Włodarczyk, Natalia Żeber-Lubecka","doi":"10.1177/22840265231181265","DOIUrl":"https://doi.org/10.1177/22840265231181265","url":null,"abstract":"We would like to announce a new vision of the Journal of Endometriosis and Pelvic Pain Disorders. Thanks to the contribution by former Editors-in-Chief, Associate Editors, and Editorial Board members, as well as all Readers we have a stable base and our journal is still growing. Today, it is safe to say that the journal has already matured and that it has a specific goal, specific groups of authors and readers—each of them is unique. The audience of our magazine mostly includes clinicians and scientists dealing with the subject of broadly understood gynecology with an emphasis on minimally-invasive gynecology, as well as the issues of pathophysiology, particularly comprising the topic of endometriosis, pelvic pain, reproduction, uterine fibroids, or some parts of endocrinology or gynecological oncology. Currently, our journal publishes a high quality peer-reviewed basic and clinical original research articles and critical reviews focusing specifically on the diagnosis, medical, and surgical treatment of endometriosis, adenomyosis, and associated disorders in all their multidimensional aspects. In our strategy for the forthcoming years, we will especially keep place for the most important current problems, controversial or unresolved topics in particular, which are not lacking in case of such a poorly understood pathology as endometriosis, pelvic pain, or uterine fibroids. To sum up, we believe that our journal will surely continue developing in all most important areas of clinical and scientific publishing—these mean standards, basic research, translational medicine, and clinical concept.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"55 - 57"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47987529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/22840265231178332
C. Arkfeld, Julia Gelissen, A. Upadhyay, G. Altwerger
Background: Endometriosis is a common gynecological condition that often presents with pelvic pain and infertility, but in rare cases may masquerade as a gastrointestinal or gynecologic malignancy. Case: A 49-year-old G0 presented with abdominal pain, fevers, elevated tumor markers, and a large adnexal mass concerning for malignancy. Intra-operatively, mucinous lesions diffusely involved abdominopelvic structures. Intra-operative frozen section (IOFS) revealed invasive cancer and full cytoreductive surgery was completed. Final pathology was downgraded to atypical cystic endometriosis with mucinous metaplasia. Conclusion: Endometriosis, a nonmalignant condition, can present as pelvic masses associated with elevated tumor markers. The case presented here depicts a confounding preoperative and intraoperative picture where endometriosis was falsely identified as malignancy. Endometriosis should always remain a part of the differential diagnosis in a premenopausal patient with presumed gastrointestinal or gynecologic malignancies.
{"title":"Deep infiltrating endometriosis with mucinous metaplasia of mullerian origin","authors":"C. Arkfeld, Julia Gelissen, A. Upadhyay, G. Altwerger","doi":"10.1177/22840265231178332","DOIUrl":"https://doi.org/10.1177/22840265231178332","url":null,"abstract":"Background: Endometriosis is a common gynecological condition that often presents with pelvic pain and infertility, but in rare cases may masquerade as a gastrointestinal or gynecologic malignancy. Case: A 49-year-old G0 presented with abdominal pain, fevers, elevated tumor markers, and a large adnexal mass concerning for malignancy. Intra-operatively, mucinous lesions diffusely involved abdominopelvic structures. Intra-operative frozen section (IOFS) revealed invasive cancer and full cytoreductive surgery was completed. Final pathology was downgraded to atypical cystic endometriosis with mucinous metaplasia. Conclusion: Endometriosis, a nonmalignant condition, can present as pelvic masses associated with elevated tumor markers. The case presented here depicts a confounding preoperative and intraoperative picture where endometriosis was falsely identified as malignancy. Endometriosis should always remain a part of the differential diagnosis in a premenopausal patient with presumed gastrointestinal or gynecologic malignancies.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"91 - 94"},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44867061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-18DOI: 10.1177/22840265231170912
Ashley Murphy Shaw, Kara Demarco, Laura Belovs, R. Strange, Trimble Spitzer
Introduction: While the diagnosis of endometriosis is relatively common, thoracic endometriosis is a rare manifestation. Thoracic Endometriosis Syndrome (TES) most commonly presents with pneumothorax, 3% which are bilateral, making this case unique in the already limited breadth of TES with catamenial hemopneumothorax. Additionally, this patient had laboratory values constant with ovarian suppression yet continued menses and recurrent hemopneumothorax, necessitating surgical intervention. We propose that with this severity of disease a combination of surgical intervention and hormonal therapy is the ideal approach, providing the lowest rate of recurrence. Case description: A 33 year old woman with 2-day history of chest pain and shortness of breath with heavy menstrual cycles and significant dysmenorrhea. A chest radiograph and computed tomography scan revealed right-sided pneumothorax and bilateral hemothoraces with left-sided diaphragmatic hernia. Video-assisted thoracoscopic surgery confirmed sanguinous pleural effusions and biopsy proven endometriotic lesions. The patient was started on a gonadotropin-releasing hormone agonist and experienced short-interval recurrence of her symptoms. An aromatase inhibitor was added to her regimen and she underwent a left diaphragmatic hernia repair. Conclusions: The recurrence of symptoms despite complete hypothalamic-pituitary-ovarian axis suppression, in addition to the surgical requirements and findings make this case unique in the already limited breadth of thoracic endometriosis syndrome with catamenial hemopneumothorax.
{"title":"Diagnosis and management of thoracic endometriosis syndrome: Case report","authors":"Ashley Murphy Shaw, Kara Demarco, Laura Belovs, R. Strange, Trimble Spitzer","doi":"10.1177/22840265231170912","DOIUrl":"https://doi.org/10.1177/22840265231170912","url":null,"abstract":"Introduction: While the diagnosis of endometriosis is relatively common, thoracic endometriosis is a rare manifestation. Thoracic Endometriosis Syndrome (TES) most commonly presents with pneumothorax, 3% which are bilateral, making this case unique in the already limited breadth of TES with catamenial hemopneumothorax. Additionally, this patient had laboratory values constant with ovarian suppression yet continued menses and recurrent hemopneumothorax, necessitating surgical intervention. We propose that with this severity of disease a combination of surgical intervention and hormonal therapy is the ideal approach, providing the lowest rate of recurrence. Case description: A 33 year old woman with 2-day history of chest pain and shortness of breath with heavy menstrual cycles and significant dysmenorrhea. A chest radiograph and computed tomography scan revealed right-sided pneumothorax and bilateral hemothoraces with left-sided diaphragmatic hernia. Video-assisted thoracoscopic surgery confirmed sanguinous pleural effusions and biopsy proven endometriotic lesions. The patient was started on a gonadotropin-releasing hormone agonist and experienced short-interval recurrence of her symptoms. An aromatase inhibitor was added to her regimen and she underwent a left diaphragmatic hernia repair. Conclusions: The recurrence of symptoms despite complete hypothalamic-pituitary-ovarian axis suppression, in addition to the surgical requirements and findings make this case unique in the already limited breadth of thoracic endometriosis syndrome with catamenial hemopneumothorax.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"86 - 90"},"PeriodicalIF":0.5,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47070858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-05DOI: 10.1177/22840265231165555
J. Griffin, Ahmed H Abdulrahim, Breanna M. Elger, Poonam Sharma, Teresa A. Hilgers
Background: Struma peritonei is an extremely rare presentation of struma ovarii. Case: Here we report the case of a 38-year-old woman with a history of papillary thyroid cancer, left ovary struma ovarii, ruptured mature cystic teratoma of the right ovary, and endometriosis presenting with pelvic pain, dysmenorrhea, abnormal uterine bleeding, and infertility. A diagnostic laparoscopy was performed to evaluate for recurrence of endometriosis. However, multiple abnormal appearing lesions were found on her left hemidiaphragm and left abdominal wall. The tissue was identified as ectopic thyroid tissue identical to the patients ruptured mature cystic teratoma which occurred 15 years prior. A second subsequent laparoscopy was performed to excise the lesions. Eleven additional lesions were identified as ectopic thyroid tissue. This peritoneal dissemination was likely a result of tissue seeding post-mature teratoma rupture. Conclusion: Gynecologists should consider the possibility of struma peritonei in patients who have a history of papillary thyroid cancer and struma ovarii who present with significant pelvic pain and abnormal uterine bleeding.
{"title":"Diagnosis of struma peritonei 15 years after rupture of mature teratoma","authors":"J. Griffin, Ahmed H Abdulrahim, Breanna M. Elger, Poonam Sharma, Teresa A. Hilgers","doi":"10.1177/22840265231165555","DOIUrl":"https://doi.org/10.1177/22840265231165555","url":null,"abstract":"Background: Struma peritonei is an extremely rare presentation of struma ovarii. Case: Here we report the case of a 38-year-old woman with a history of papillary thyroid cancer, left ovary struma ovarii, ruptured mature cystic teratoma of the right ovary, and endometriosis presenting with pelvic pain, dysmenorrhea, abnormal uterine bleeding, and infertility. A diagnostic laparoscopy was performed to evaluate for recurrence of endometriosis. However, multiple abnormal appearing lesions were found on her left hemidiaphragm and left abdominal wall. The tissue was identified as ectopic thyroid tissue identical to the patients ruptured mature cystic teratoma which occurred 15 years prior. A second subsequent laparoscopy was performed to excise the lesions. Eleven additional lesions were identified as ectopic thyroid tissue. This peritoneal dissemination was likely a result of tissue seeding post-mature teratoma rupture. Conclusion: Gynecologists should consider the possibility of struma peritonei in patients who have a history of papillary thyroid cancer and struma ovarii who present with significant pelvic pain and abnormal uterine bleeding.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"82 - 85"},"PeriodicalIF":0.5,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42271738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/22840265231161868
A. Jalaeefar, B. Eslami, M. Bahar, R. Hosseini, Amirsina Sharifi, N. Rakhshani, A. Moini
Introduction: Recent studies have proposed that advanced endometriosis might harbor histopathological, molecular, and genetic properties of malignant lesion. Thus we aimed to investigate the presence of Ki-67 staining index (KSI) and BRAF mutation in patients with and without recurrent endometriosis of stage III and IV. Materials and methods: Cross sectional study on 50 consecutive patients with endometriosis of stage III and IV was performed. Tissue specimens collected during laparoscopic surgery were used for the evaluation of presence of KSI and BRAF mutation. Also, serum levels of tumor markers including CA-125, CA19-9, AMH and αFP were gathered. Results: The mean ± SD of KSI was 12.18 ± 16.58. Forty-one out of 50 (82%) patients had a non-recurrent disease. KSI ⩾ 10% was found in 20 patients (40%). Furthermore, 29 patients (58%) and 13 patients (26%) had high levels of CA-125 and CA19-9, respectively. No evidence of significant correlation was observed between the KSI and CA-125 and CA19-9 (all p values > 0.05). However, a positive correlation was observed between CA-125 and CA19-9 (r = 0.55, p-value = 0.02). KSI level was insignificantly lower in recurrent patients compared with non-recurrent patients (9.78 ± 6.24 vs 12.71 ± 18.09, p-value = 0.33). Other tumor markers did not show any statistically significant difference (all p values > 0.05). None of the participants had BRAF V600E mutation. Conclusion: Endometriosis manifests malignant behavioral of rapid proliferation but the exact genetic alteration causing this phenomenon is not understood.
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