Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature

Beavis, Anna; Matsuo, Koji; Grubbs, Brendan H.; Srivastava, Sanvesh; Truong, Christina; Moffitt, Melissa; Maliglig, Ana; Lin, Yvonne G.

doi:10.1016/j.fertnstert.2011.01.157

Cited by 12 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common symptoms, chronic pelvic pain and infertility, drastically impact the quality of patients' lives (1). Endometriosis is categorized as the growth of endometrial-like tissue lesions in extrauterine locations; commonly found on the peritoneum, sigmoid colon, ovary, and uterine ligaments and less commonly found in lymph nodes, pleural tissue, and cardiac tissue (2,3). Despite decades of research, we still do not have reliable, noninvasive diagnostic markers for endometriosis or consistently effective and tolerable treatment options.…”

mentioning

confidence: 99%

T helper 17 axis and endometrial macrophage disruption in menstrual effluent provides potential insights into the pathogenesis of endometriosis

et al. 2022

View full text Add to dashboard Cite

mentioning

confidence: 99%

T helper 17 axis and endometrial macrophage disruption in menstrual effluent provides potential insights into the pathogenesis of endometriosis

et al. 2022

View full text Add to dashboard Cite

“…There are three previous reports in the literature (Table 1 ). In 2011 Beavis et al reported the first case of EMs of para-aortic lymph nodes of a pregnant woman [ 18 ]. The patient was a 25-year-old multipara pregnant woman with a history of chronic pelvic pain and ovarian cystectomies for bilateral endometriomas.…”

Section: Discussionmentioning

confidence: 99%

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

Liu

et al. 2022

BMC Women's Health

View full text Add to dashboard Cite

Background Endometriosis is a common benign gynecological disease characterized by growing-functioning endometrial tissue outside the uterus. Extra-pelvic endometriosis, which accounts for approximately 12% of endometriosis, is more challenging to diagnose because of its distance from the pelvic organs. Halban's theory of benign metastasis indicates that endometrial cells can appear in extra-pelvic organs via lymphatic and blood vessels, but endometrial lymph node metastasis cases are still rare. We report a case of endometriosis in a para-aortic lymph node whose clinical behavior mimicked a malignancy. Case presentation A 52-year-old perimenopausal woman underwent laparoscopic hysterectomy plus bilateral salpingectomy (the patient insisted on the preservation of her ovaries) at a local hospital 2 years earlier because of adenomyosis. The patient presented with a complaint of low back pain to the gastrointestinal outpatient department of our hospital. The carbohydrate antigen 125 (CA125) was abnormally elevated at 5280.20 U/ml, human epididymis 4 (HE4) was 86.0 pmol/L, while other tumor markers were normal. Serum female hormone results were in the postmenopausal range, and her gastroenteroscopy showed no abnormalities. Moreover, both enhanced magnetic resonance imaging and positron emission tomography-computed tomography showed a high possibility of a retroperitoneal malignant lymph node (metastasis possible, primary site unknown). One week after admission, she underwent laparoscopic exploratory surgery, during which we observed normal shape and size of both ovaries while the left ovary was cystic-solid. After opening the retroperitoneal space, an enlarged lymph node-like tissue measuring 8 × 4 × 3 cm3 was found near the abdominal aorta. When the surrounding adhesions were separated, lymph node-like tissue was poorly demarcated from the abdominal aorta and renal artery. Some lymph node samples and left ovary were sent for intraoperative frozen section, which revealed benign lesions, similar to endometrial tissue. The lymph node tissue was then excised as much as possible, and the second set of intraoperative frozen sections showed high probability of endometrial tissue. The final histopathology and immunohistochemistry staining reached a diagnosis of para-aortic lymph node endometriosis. Gonadotropin-releasing hormone antigen treatment was recommended every 28 days because of the high preoperative CA125 and imaging-based suspicion of malignancy. The serum CA125 subsequently decreased to normal levels, and no para-aortic lesions were detected on abdominal enhancement CT. She is being followed up regularly. Conclusion It is known that the incidence of lymph node metastasis in pelvic endometriosis is relatively rare. Our report shows that endometriotic tissue can metastasize via the lymphatic route and suggests that endometriotic tissue has the characteristics of invasion and metastasis.

show abstract

“…The lymphatic dissemination theory has been proposed to explain the observations of endometrial tissue moving through the vasculature and lymph nodes [ 30 ]. Lymphatic system involvement may explain the reason why endometrial tissue can be found in rare areas outside the peritoneal cavity or ovaries, such as the pleura or the pericardium [ 31 ]. In this case, understanding the role of the lymphatic system in endometriosis is essential to establish novel therapeutic approaches for the disease.…”

Section: Postulated Originsmentioning

confidence: 99%

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

Ochoa Bernal,

Fazleabas

2024

IJMS

View full text Add to dashboard Cite

Endometriosis is one of the most common causes of chronic pelvic pain and infertility, affecting 10% of women of reproductive age. A delay of up to 9 years is estimated between the onset of symptoms and the diagnosis of endometriosis. Endometriosis is currently defined as the presence of endometrial epithelial and stromal cells at ectopic sites; however, advances in research on endometriosis have some authors believing that endometriosis should be re-defined as “a fibrotic condition in which endometrial stroma and epithelium can be identified”. There are several theories on the etiology of the disease, but the origin of endometriosis remains unclear. This review addresses the role of microRNAs (miRNAs), which are naturally occurring post-transcriptional regulatory molecules, in endometriotic lesion development, the inflammatory environment within the peritoneal cavity, including the role that cytokines play during the development of the disease, and how animal models have helped in our understanding of the pathology of this enigmatic disease.

show abstract

Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature

Cited by 12 publications

References 20 publications

T helper 17 axis and endometrial macrophage disruption in menstrual effluent provides potential insights into the pathogenesis of endometriosis

T helper 17 axis and endometrial macrophage disruption in menstrual effluent provides potential insights into the pathogenesis of endometriosis

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

Contact Info

Product

Resources

About