Histologic analysis of endometriomas: what the surgeon needs to know.

Abstract:

OBJECTIVE:To evaluate by thorough pathologic analysis the histologic features of the endometrioma wall excised at laparoscopy. DESIGN:Prospective series of consecutive patients. SETTING:Tertiary care, university hospital. PATIENT(S):Fifty-nine patients with ovarian endometriomas. A total of 70 cysts were examined. INTERVENTION(S):Patients underwent operative laparoscopy with the stripping technique for excision of the ovarian endometrioma. MAIN OUTCOME MEASURE(S):A thorough histologic examination was performed on the entire cyst wall specimen. RESULT(S):Histologic examination confirmed the endometriotic nature of the cyst in 100% of the cases. The inner wall of the endometrioma was covered by endometriotic tissue on 60% of the surface. The mean cyst wall thickness was 1.4 mm. The mean value of maximal depth of endometriosis penetration in the endometrioma wall was 0.6 mm. In 99% of the cases the maximal penetration of the endometriotic tissue was <1.5 mm. CONCLUSION(S):In the present study, we demonstrate that the endometrioma wall contains endometriotic tissue in 100% of the cases. However, the endometriotic tissue may cover the inner cyst wall for a surface that varies between 10% and 98% of the entire wall (median value 60%). This tissue may reach a depth of 2 mm, but for most of the surface it does not penetrate >1.5 mm. These histologic data may help the gynecologic laparoscopist select the surgical approach that maximally preserves healthy ovarian tissue.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Muzii L,Bianchi A,Bellati F,Cristi E,Pernice M,Zullo MA,Angioli R,Panici PB

doi

10.1016/j.fertnstert.2006.06.055

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

362-6

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(06)03848-9

journal_volume

87

pub_type

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