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Archives of Gynecology and Obstetrics

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01-12-2012 | Reproductive Medicine

Endometriosis in menopause: a single institution experience

Authors: Matteo Morotti, Valentino Remorgida, Pier Luigi Venturini, Simone Ferrero

Published in: Archives of Gynecology and Obstetrics | Issue 6/2012

Abstract

Purpose

This study aims to present the clinical characteristics of a series of postmenopausal women with endometriosis and to evaluate the preferential location, extension and histopathological features of the lesions.

Methods

We retrospectively examined the clinical records of 72 postmenopausal women with endometriosis who underwent surgery between January 1998 and December 2010.

Results

The median age of patients at the time of surgery was 58.5 years. Eleven patients (15.3 %) had previous history of endometriosis and five patients had previously undergone surgery for this reason. Only two patients included in the study were using hormone replacement therapy at the time of surgery. The most frequent location of endometriotic lesions was the ovary and among patients with endometriomas, 35 % (20/57) had different grades of metaplasia, hyperplasia, atypia and endometrioid carcinoma arising in endometriosis. The proportions of epithelium, stroma and hemorrhage in endometriotic lesions were higher in patients with concomitant endometrial or ovarian cancer.

Conclusions

Endometriosis should be considered in the differential diagnosis of postmenopausal cystic lesions of the ovary. The administration of exogenous estrogen is not a prerequisite for the presence of endometriosis in postmenopausal women, and histological signs of functionally active lesions were also observed in the absence of exogenous hormone intake.

Gurates B, Bulun SE (2003) Endometriosis: the ultimate hormonal disease. Semin Reprod Med 21:125–134PubMedCrossRef

Ferrero S, Arena E, Morando A, Remorgida V (2010) Prevalence of newly diagnosed endometriosis in women attending the general practitioner. Int J Gynaecol Obstet 110:203–207PubMedCrossRef

Giudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799PubMedCrossRef

Fagervold B, Jenssen M, Hummelshoj L, Moen MH (2009) Life after a diagnosis with endometriosis—a 15 years follow-up study. Acta Obstet Gynecol Scand 88:914–919PubMedCrossRef

Punnonen R, Klemi PJ, Nikkanen V (1980) Postmenopausal endometriosis. Eur J Obstet Gynecol Reprod Biol 11:195–200PubMedCrossRef

Henriksen E (1955) Endometriosis. Am J Surg 90:331–337PubMedCrossRef

Ranney B (1971) Endometriosis. III complete operations. Am J Obstet Gynecol 109:1137–1144PubMed

Rattanachaiyanont M, Angsuwatthana S, Inthawiwat S, Techatraisak K, Inthawiwat S, Leerasiri P (2003) Hormonal replacement therapy in surgical menopause with underlying endometriosis. J Med Assoc Thail 86:702–707

Al Kadri H, Hassan S, Al-Fozan HM, Hajeer A (2009) Hormone therapy for endometriosis and surgical menopause. Cochrane Database Syst Rev 21:CD005997

10.

Rosa-e-Silva JC, Carvalho BR, Hde Barbosa, Poli-Neto OB, Rosa-e-Silva AC, Candido-dos-Reis FJ, Nogueira AA (2008) Endometriosis in postmenopausal women without previous hormonal therapy: report of three cases. Climacteric 11:525–528PubMedCrossRef

11.

Cumiskey J, Whyte P, Kelehan P, Gibbons D (2008) A detailed morphologic and immunohistochemical comparison of pre- and postmenopausal endometriosis. J Clin Pathol 61:455–459PubMedCrossRef

12.

Kemper RD, Dockerty MB, Hunt AB, Symmonds RE (1960) Significant postmenopausal endometriosis. Surg Gynecol Obstet 111:348–356

13.

Oxholm D, Knudsen UB, Kryger-Baggesen N, Ravn P (2007) Postmenopausal endometriosis. Acta Obstet Gynecol Scand 4:1–7

14.

Bailey AP, Schutt AK, Modesitt SC (2010) Florid endometriosis in a postmenopausal woman. Fertil Steril 94:e1–e4CrossRef

15.

Maeda T, Uchida Y, Nakajima F (2009) Vesical endometriosis following the menopause. Int Urogynecol J Pelvic Floor Dysfunct 20:1515–1517PubMedCrossRef

16.

Deval B, Rafii A, Felce Dachez M, Kermanash R, Levardon M (2002) Sigmoid endometriosis in a postmenopausal woman. Am J Obstet Gynecol 187:1723–1725PubMedCrossRef

17.

Ackerman GE, Smith ME, Mendelson CR, MacDonald PC, Simpson ER (1981) Aromatization of androstenedione by human adipose tissue stromal cells in monolayer culture. J Clin Endocrinol Metab 53:412–417PubMedCrossRef

18.

Velasco I, Rueda J, Acién P (2006) Aromatase expression in endometriotic tissue and cell cultures of patients with endometriosis. Human Reprod 12:377–381CrossRef

19.

Zeitoun KM, Bulun SE (1999) Aromatase: a key molecule in the pathophysiology of endometriosis and a therapeutic target. Fertil Steril 72:961–969PubMedCrossRef

20.

Colette S, Lousse JC, Defrère S, Curaba M, Heilier JF, Van Langendonckt A, Mestdagt M, Foidart JM, Loumaye E, Donnez J (2009) Absence of aromatase protein and mRNA expression in endometriosis. Hum Reprod 24:2133–2141PubMedCrossRef

21.

Somigliana E, Vigano’ P, Parazzini F, Stoppelli S, Giambattista E, Vercellini P (2006) Association between endometriosis and cancer: a comprehensive review and a critical analysis of clinical and epidemiological evidence. Gynecol Oncol 101:331–341PubMedCrossRef

22.

Zanetta GM, Webb MJ, Li H, Keeney GL (2000) Hyperestrogenism: a relevant risk factor for the development of cancer from endometriosis. Gynecol Oncol 79:18–22PubMedCrossRef

23.

Soliman NF, Hillard TC (2006) Hormone replacement therapy in women with past history of endometriosis. Climacteric 9:325–335PubMedCrossRef

24.

Christodoulakos G, Augoulea A, Lambrinoudaki I, Sioulas V, Creatsas G (2007) Pathogenesis of endometriosis: the role of defective ‘immunosurveillance’. Eur J Contracept Reprod Health Care 12:194–202PubMedCrossRef

25.

Manero MG, Royo P, Olartecoechea B, Alcazar JL (2009) Endometriosis in a postmenopausal woman without previous hormonal therapy: a case report. J Med Case Reports 18:13

26.

Protopapas AG, Diakomanolis ES, Milingos SD, Rodolakis AJ, Markaki SN, Vlachos GD, Papadopoulos DE, Michalas SP (2004) Tubo-ovarian abscesses in postmenopausal women: gynecological malignancy until proven otherwise? Eur J Obstet Gynecol Reprod Biol 114:203–209PubMedCrossRef

27.

Faure AC, Faure C, Messica O, Margossian H, Ory JP (2011) Perimenopausal discovery of endometriomas on ovarian abscess. Gynecol Obstet Fertil 39:e20–e22PubMedCrossRef

28.

Chen MJ, Yang JH, Yang YS, Ho HN (2004) Increased occurrence of tubo-ovarian abscesses in women with stage III and IV endometriosis. Fertil Steril 82:498–499PubMedCrossRef

Title: Endometriosis in menopause: a single institution experience
Authors: Matteo Morotti
Valentino Remorgida
Pier Luigi Venturini
Simone Ferrero
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 6/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-012-2473-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endometriosis in menopause: a single institution experience

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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