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Extrapelvic endometriosis: a rare entity or an under diagnosed condition?

Nikolaos Machairiotis1, Aikaterini Stylianaki2, Georgios Dryllis3, Paul Zarogoulidis4*, Paraskevi Kouroutou5, Nikolaos Tsiamis1, Nikolaos Katsikogiannis6, Eirini Sarika6, Nikolaos Courcoutsakis7, Theodora Tsiouda8, Andreas Gschwendtner9, Konstantinos Zarogoulidis4, Leonidas Sakkas10, Aggeliki Baliaka10 and Christodoulos Machairiotis1

Author Affiliations

1 Obstetric - Gynecology Department, ”Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece

2 Surgery Department, “Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece

3 Internal Medicine Department, General Hospital of Syros, Nikiforou Mandilara, 84100 Island of Syros, Greece

4 Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Exohi 1100, 57010 Thessaloniki, Greece

5 1st Internal Medicine Department, “Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece

6 Surgery Department (NHS), University General Hospital of Alexandroupolis, Nea Makri, 68100 Alexandroupolis, Greece

7 Radiology Department, University General Hospital of Alexandroupolis, Nea Makri, 68100 Alexandroupolis, Greece

8 Internal Medicine Department, “Theiageneio” Anticancer Hospital, Alexander Simeonidi 2, 54007 Thessaloniki, Greece

9 Pathology Department, Hospital of Amberg, Mariahilfbergweg 5-7, 92224 Amberg, Germany

10 Pathology Department, “G. Papanikolaou” General Hospital, Exohi 1100, 57010 Thessaloniki, Greece

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Diagnostic Pathology 2013, 8:194  doi:10.1186/1746-1596-8-194

Published: 2 December 2013

Abstract

Endometriosis is a clinical entity characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Endometriosis can be either endopelvic or extrapelvicdepending on the location of endometrial tissue implantation. Despite the rarity of extrapelvic endometriosis, several cases of endometriosis of the gastrointestinal tract, the urinarytract, the upper and lower respiratory system, the diaphragm, the pleura and the pericardium, as well as abdominal scars loci have been reported in the literature. There are several theories about the pathogenesis and the pathophysiology of endometriosis. Depending on the place of endometrial tissue implantation, endometriosis can be expressed with a wide variety of symptoms. The diagnosis of this entity is neither easy nor routine. Many diagnostic methods clinical and laboratory have been used, but none of them is the golden standard. The multipotent localization of endometriosis in combination with the wide range of its clinical expression should raise the clinical suspicion in every woman with periodic symptoms of extrapelvic organs. Finally, the therapeutic approach of this clinical entity is also correlated with the bulk of endometriosis and the locum that it is found. It varies from simple observation, to surgical treatment and treatment with medication as well as a combination of those.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1968087883113362 webcite.

Keywords:
Endometriosis; Lung; Ovary; Molecular pathways; Treatment