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

Diagnostic Pathology

Christodoulos Machairiotis³  Aggeliki Baliaka⁹  Leonidas Sakkas⁹  Konstantinos Zarogoulidis⁶  Andreas Gschwendtner¹  Theodora Tsiouda⁴  Nikolaos Courcoutsakis²  Eirini Sarika⁵  Nikolaos Katsikogiannis⁵  Nikolaos Tsiamis³  Paraskevi Kouroutou⁸  Paul Zarogoulidis⁶  Georgios Dryllis^1,10  Aikaterini Stylianaki⁷  Nikolaos Machairiotis³ 

[1] Pathology Department, Hospital of Amberg, Mariahilfbergweg 5-7, 92224 Amberg, Germany;Radiology Department, University General Hospital of Alexandroupolis, Nea Makri, 68100 Alexandroupolis, Greece;Obstetric - Gynecology Department, ”Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece;Internal Medicine Department, “Theiageneio” Anticancer Hospital, Alexander Simeonidi 2, 54007 Thessaloniki, Greece;Surgery Department (NHS), University General Hospital of Alexandroupolis, Nea Makri, 68100 Alexandroupolis, Greece;Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Exohi 1100, 57010 Thessaloniki, Greece;Surgery Department, “Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece;1st Internal Medicine Department, “Thriassio” General Hospital of Athens, George Genimata, 19600 Athens, Greece;Pathology Department, “G. Papanikolaou” General Hospital, Exohi 1100, 57010 Thessaloniki, Greece;Internal Medicine Department, General Hospital of Syros, Nikiforou Mandilara, 84100 Island of Syros, Greece

关键词: Treatment;    Molecular pathways;    Ovary;    Lung;    Endometriosis;   

Others  :  1217817
DOI  :  10.1186/1746-1596-8-194

 received in 2013-11-15, accepted in 2013-11-23,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Machairiotis et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Cassina PC, Hauser M, Kacl G, Imthurn B, Schroder S, Weder W: Catamenial hemoptysis. Diagnosis with MRI. Chest 1997, 111:1447-1450.
• [2]Dragoumis K, Mikos T, Zafrakas M, Assimakopoulos E, Stamatopoulos P, Bontis J: Endometriotic uterocutaneous fistula after cesarean section. A case report. Gynecol Obstet Invest 2004, 57:90-92.
• [3]Huanwen W, Hui Z, Xiaowei X, Zhaohui L: Extrauterine adenomyoma of the liver with a focally cellular smooth muscle component occurring in a patient with a history of myomectomy: case report and review of the literature. Diagn Pathol 2013, 8:131. BioMed Central Full Text
• [4]Yu JH, Lin XY, Wang L, Liu Y, Fan CF, Zhang Y, Wang EH: Endobronchial endometriosis presenting as central-type lung cancer: a case report. Diagn Pathol 2013, 8:53. BioMed Central Full Text
• [5]Uehara K, Yasuda M, Ichimura T, Yamaguchi H, Nagata K, Kayano H, Sasaki A, Murata S, Shimizu M: Peritoneal keratin granuloma associated with endometrioid adenocarcinoma of the uterine corpus. Diagn Pathol 2011, 6:104. BioMed Central Full Text
• [6]Emmanuel R, Lea M, Claude P, Antonio V, Marianne Z, Christophe P, Christophe B: Ileocolic intussusception due to a cecal endometriosis: case report and review of literature. Diagn Pathol 2012, 7:62. BioMed Central Full Text
• [7]Fadare O, Zheng W: Endometrial Glandular Dysplasia (EmGD): morphologically and biologically distinctive putative precursor lesions of Type II endometrial cancers. Diagn Pathol 2008, 3:6. BioMed Central Full Text
• [8]Terada S, Miyata Y, Nakazawa H, Higashimori T, Arai T, Kikuchi Y, Nozaki M: Immunohistochemical analysis of an ectopic endometriosis in the uterine round ligament. Diagn Pathol 2006, 1:27. BioMed Central Full Text
• [9]Simoglou C, Zarogoulidis P, Machairiotis N, Porpodis K, Simoglou L, Mitrakas A, Esebidis A, Sarika E, Kouklakis G, Iordanidis A, Katsikogiannis N: Abdominal wall endometrioma mimicking an incarcerated hernia: a case report. Intern J Gen Med 2012, 5:569-571.
• [10]Bulletti C, Coccia ME, Battistoni S, Borini A: Endometriosis and infertility. J Assist Reprod Genet 2010, 27:441-447.
• [11]Giarenis I, Giamougiannis P, Speakman CT, Nieto JJ, Crocker SG: Recurrent endometriosis following total hysterectomy with oophorectomy mimicking a malignant neoplastic lesion: a diagnostic and therapeutic challenge. Arch Gynecol Obstet 2009, 279:419-421.
• [12]Erzen M, Kovacic J: Relationship between endometriosis and ovarian cancer. Eur J Gynaecol Oncol 1998, 19:553-555.
• [13]Somigliana E, Vigano P, Parazzini F, Stoppelli S, Giambattista E, Vercellini P: Association between endometriosis and cancer: a comprehensive review and a critical analysis of clinical and epidemiological evidence. Gynecol Oncol 2006, 101:331-341.
• [14]Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P: High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod 2002, 17:2715-2724.
• [15]Sangi-Haghpeykar H, Poindexter AN 3rd: Epidemiology of endometriosis among parous women. Obstet Gynecol 1995, 85:983-992.
• [16]Eskenazi B, Warner ML: Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997, 24:235-258.
• [17]Bischoff FZ, Simpson JL: Heritability and molecular genetic studies of endometriosis. Hum Reprod Update 2000, 6:37-44.
• [18]Simpson JL, Bischoff FZ, Kamat A, Buster JE, Carson SA: Genetics of endometriosis. Obstet Gynecol Clin North Am 2003, 30:21-40. vii
• [19]Simpson JL, Elias S, Malinak LR, Buttram VC Jr: Heritable aspects of endometriosis. I. Genetic studies. Am J Obstet Gynecol 1980, 137:327-331.
• [20]Lamb K, Hoffmann RG, Nichols TR: Family trait analysis: a case–control study of 43 women with endometriosis and their best friends. Am J Obstet Gynecol 1986, 154:596-601.
• [21]Treloar SA, O’Connor DT, O’Connor VM, Martin NG: Genetic influences on endometriosis in an Australian twin sample. [e-mail]. Fertil Steril 1999, 71:701-710.
• [22]Hadfield RM, Mardon HJ, Barlow DH, Kennedy SH: Endometriosis in monozygotic twins. Fertil Steril 1997, 68:941-942.
• [23]Evian Annual Reproduction Workshop G, Fauser BC, Diedrich K, Bouchard P, Dominguez F, Matzuk M, Franks S, Hamamah S, Simon C, Devroey P, et al.: Contemporary genetic technologies and female reproduction. Hum Reprod Update 2011, 17:829-847.
• [24]Giudice LC, Kao LC: Endometriosis. Lancet 2004, 364:1789-1799.
• [25]Treloar SA, Wicks J, Nyholt DR, Montgomery GW, Bahlo M, Smith V, Dawson G, Mackay IJ, Weeks DE, Bennett ST, et al.: Genomewide linkage study in 1,176 affected sister pair families identifies a significant susceptibility locus for endometriosis on chromosome 10q26. Am J Hum Genet 2005, 77:365-376.
• [26]Painter JN, Anderson CA, Nyholt DR, Macgregor S, Lin J, Lee SH, Lambert A, Zhao ZZ, Roseman F, Guo Q, et al.: Genome-wide association study identifies a locus at 7p15.2 associated with endometriosis. Nat Genet 2011, 43:51-54.
• [27]Gleicher N, el-Roeiy A, Confino E, Friberg J: Is endometriosis an autoimmune disease? Obstet Gynecol 1987, 70:115-122.
• [28]Capellino S, Montagna P, Villaggio B, Sulli A, Soldano S, Ferrero S, Remorgida V, Cutolo M: Role of estrogens in inflammatory response: expression of estrogen receptors in peritoneal fluid macrophages from endometriosis. Ann N Y Acad Sci 2006, 1069:263-267.
• [29]Rier SE, Turner WE, Martin DC, Morris R, Lucier GW, Clark GC: Serum levels of TCDD and dioxin-like chemicals in Rhesus monkeys chronically exposed to dioxin: correlation of increased serum PCB levels with endometriosis. Toxicol Sci 2001, 59:147-159.
• [30]Guo SW: The link between exposure to dioxin and endometriosis: a critical reappraisal of primate data. Gynecol Obstet Invest 2004, 57:157-173.
• [31]Guo SW, Simsa P, Kyama CM, Mihalyi A, Fulop V, Othman EE, D’Hooghe TM: Reassessing the evidence for the link between dioxin and endometriosis: from molecular biology to clinical epidemiology. Mol Hum Reprod 2009, 15:609-624.
• [32]van der Linden PJ: Theories on the pathogenesis of endometriosis. Human Reprod 1996, 11(Suppl 3):53-65.
• [33]Donnez J, Van Langendonckt A, Casanas-Roux F, Van Gossum JP, Pirard C, Jadoul P, Squifflet J, Smets M: Current thinking on the pathogenesis of endometriosis. Gynecol Obstet Invest 2002, 54(Suppl 1):52-58. discussion 59–62
• [34]Starzinski-Powitz A, Handrow-Metzmacher H, Kotzian S: The putative role of cell adhesion molecules in endometriosis: can we learn from tumour metastasis? Mol Med Today 1999, 5:304-309.
• [35]Obata K, Hoshiai H: Common genetic changes between endometriosis and ovarian cancer. Gynecol Obstet Invest 2000, 50(Suppl 1):39-43.
• [36]Thomas EJ, Campbell IG: Molecular genetic defects in endometriosis. Gynecol Obstet Invest 2000, 50(Suppl 1):44-50.
• [37]Oral E, Ilvan S, Tustas E, Korbeyli B, Bese T, Demirkiran F, Arvas M, Kosebay D: Prevalence of endometriosis in malignant epithelial ovary tumours. Eur J Obstet Gynecol Reprod Biol 2003, 109:97-101.
• [38]Modesitt SC, Tortolero-Luna G, Robinson JB, Gershenson DM, Wolf JK: Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol 2002, 100:788-795.
• [39]Vercellini P, Scarfone G, Bolis G, Stellato G, Carinelli S, Crosignani PG: Site of origin of epithelial ovarian cancer: the endometriosis connection. BJOG 2000, 107:1155-1157.
• [40]Borgfeldt C, Andolf E: Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis. Acta Obstet Gynecol Scand 2004, 83:395-400.
• [41]Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A: Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol 1997, 176:572-579.
• [42]Zafrakas M, Tarlatzis BC, Streichert T, Pournaropoulos F, Wolfle U, Smeets SJ, Wittek B, Grimbizis G, Brakenhoff RH, Pantel K, et al.: Genome-wide microarray gene expression, array-CGH analysis, and telomerase activity in advanced ovarian endometriosis: a high degree of differentiation rather than malignant potential. Int J Mol Med 2008, 21:335-344.
• [43]Zhou HE, Nothnick WB: The relevancy of the matrix metalloproteinase system to the pathophysiology of endometriosis. Front Biosci 2005, 10:569-575.
• [44]Szamatowicz J, Laudanski P, Tomaszewska I: Matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1: a possible role in the pathogenesis of endometriosis. Human Reprod 2002, 17:284-288.
• [45]Gaetje R, Holtrich U, Engels K, Kourtis K, Cikrit E, Kissler S, Rody A, Karn T, Kaufmann M: Expression of membrane-type 5 matrix metalloproteinase in human endometrium and endometriosis. Gynecol Endocrinol 2007, 23:567-573.
• [46]Gilabert-Estelles J, Ramon LA, Espana F, Gilabert J, Vila V, Reganon E, Castello R, Chirivella M, Estelles A: Expression of angiogenic factors in endometriosis: relationship to fibrinolytic and metalloproteinase systems. Human Reprod 2007, 22:2120-2127.
• [47]Ramon L, Gilabert-Estelles J, Castello R, Gilabert J, Espana F, Romeu A, Chirivella M, Aznar J, Estelles A: mRNA analysis of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis using a real-time quantitative RT-PCR assay. Human Reprod 2005, 20:272-278.
• [48]Gilabert-Estelles J, Estelles A, Gilabert J, Castello R, Espana F, Falco C, Romeu A, Chirivella M, Zorio E, Aznar J: Expression of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis. Human Reprod 2003, 18:1516-1522.
• [49]Chung HW, Wen Y, Chun SH, Nezhat C, Woo BH, Lake Polan M: Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-3 mRNA expression in ectopic and eutopic endometrium in women with endometriosis: a rationale for endometriotic invasiveness. Fertil Steril 2001, 75:152-159.
• [50]Kim HO, Yang KM, Kang IS, Koong MK, Kim HS, Zhang X, Kim I: Expression of CD44s, vascular endothelial growth factor, matrix metalloproteinase-2 and Ki-67 in peritoneal, rectovaginal and ovarian endometriosis. J Reprod Med 2007, 52:207-213.
• [51]Lu XE, Ning WX, Dong MY, Liu AX, Jin F, Huang HF: Vascular endothelial growth factor and matrix metalloproteinase-2 expedite formation of endometriosis in the early stage ICR mouse model. Fertil Steril 2006, 86:1175-1181.
• [52]Hudelist G, Lass H, Keckstein J, Walter I, Wieser F, Wenzl R, Mueller R, Czerwenka K, Kubista E, Singer CF: Interleukin 1alpha and tissue-lytic matrix metalloproteinase-1 are elevated in ectopic endometrium of patients with endometriosis. Hum Reprod 2005, 20:1695-1701.
• [53]Visouli AN, Darwiche K, Mpakas A, Zarogoulidis P, Papagiannis A, Tsakiridis K, Machairiotis N, Stylianaki A, Katsikogiannis N, Courcoutsakis N, Zarogoulidis K: Catamenial pneumothorax: a rare entity? Report of 5 cases and review of the literature. J Thoracic Dis 2012, 4:17-31.
• [54]Huang H, Li C, Zarogoulidis P, Darwiche K, Machairiotis N, Yang L, Simoff M, Celis E, Zhao T, Zarogoulidis K, et al.: Endometriosis of the lung: report of a case and literature review. European journal of medical research 2013, 18:13. BioMed Central Full Text
• [55]May KE, Conduit-Hulbert SA, Villar J, Kirtley S, Kennedy SH, Becker CM: Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update 2010, 16:651-674.
• [56]May KE, Villar J, Kirtley S, Kennedy SH, Becker CM: Endometrial alterations in endometriosis: a systematic review of putative biomarkers. Hum Reprod Update 2011, 17:637-653.
• [57]Ideyi SC, Schein M, Niazi M, Gerst PH: Spontaneous endometriosis of the abdominal wall. Dig Surg 2003, 20:246-248.
• [58]Patterson GK, Winburn GB: Abdominal wall endometriomas: report of eight cases. Am Surg 1999, 65:36-39.
• [59]Seydel AS, Sickel JZ, Warner ED, Sax HC: Extrapelvic endometriosis: diagnosis and treatment. Am J Surg 1996, 171:239.
• [60]Koger KE, Shatney CH, Hodge K, McClenathan JH: Surgical scar endometrioma. Surg Gynecol Obstet 1993, 177:243-246.
• [61]Dwivedi AJ, Agrawal SN, Silva YJ: Abdominal wall endometriomas. Dig Dis Sci 2002, 47:456-461.
• [62]Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH: Abdominal wall endometriomas. Am J Surg 2003, 185:596-598.
• [63]Simsir A, Thorner K, Waisman J, Cangiarella J: Endometriosis in abdominal scars: a report of three cases diagnosed by fine-needle aspiration biopsy. Am Surg 2001, 67:984-986.
• [64]Wolf C, Obrist P, Ensinger C: Sonographic features of abdominal wall endometriosis. AJR 1997, 169:916-917.
• [65]Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G: Abdominal wall endometriomas near cesarean delivery scars: sonographic and color doppler findings in a series of 12 patients. J Ultrasound Med 2003, 22:1041-1047.
• [66]Coley BD, Casola G: Incisional endometrioma involving the rectus abdominis muscle and subcutaneous tissues: CT appearance. AJR 1993, 160:549-550.
• [67]Wolf GC, Kopecky KK: MR imaging of endometriosis arising in cesarean section scar. J Comput Assist Tomogr 1989, 13:150-152.
• [68]Jablonski C, Alifano M, Regnard JF, Gompel A: Pneumoperitoneum associated with catamenial pneumothorax in women with thoracic endometriosis. Fertil Steril 2009, 91:930 e919-922.
• [69]Suginami H: A reappraisal of the coelomic metaplasia theory by reviewing endometriosis occurring in unusual sites and instances. Am J Obstet Gynecol 1991, 165:214-218.
• [70]Korom S, Canyurt H, Missbach A, Schneiter D, Kurrer MO, Haller U, Keller PJ, Furrer M, Weder W: Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg 2004, 128:502-508.
• [71]Kirschner PA: Porous diaphragm syndromes. Chest Surg Clin N Am 1998, 8:449-472.
• [72]Mignemi G, Facchini C, Raimondo D, Montanari G, Ferrini G, Seracchioli R: A case report of nasal endometriosis in a patient affected by Behcet’s disease. J Minim Invasive Gynecol 2012, 19:514-516.
• [73]Goldsmith PJ, Ahmad N, Dasgupta D, Campbell J, Guthrie JA, Lodge JP: Case hepatic endometriosis: a continuing diagnostic dilemma. HPB Surg 2009, 2009:407206.
• [74]Bouras AF, Vincentelli A, Boleslawski E, Truant S, Liddo G, Prat A, Pruvot FR, Zerbib P: Liver endometriosis presenting as a liver mass associated with high blood levels of tumoral biomarkers. Clin Res Hepatol Gastroenterol 2013, 37:e85-88.
• [75]Fluegen G, Jankowiak F, Zacarias Foehrding L, Kroepil F, Knoefel WT, Topp SA: Intrahepatic endometriosis as differential diagnosis: case report and literature review. WJG 2013, 19:4818-4822.
• [76]Kalkur S, Raza A, Richardson RE: Right upper quadrant pain? Think outside the liver: A case of diaphragmatic perihepatic endometriosis. J Obstet Gynaecol 2013, 33:743.
• [77]Watari H, Shibahara N, Ebisawa S, Nogami T, Fujimoto M, Hikiami H, Shimada Y: [Case report; A case of hepatic endometriosis with periodic right upper quadrant pain]. Nihon Naika Gakkai zasshi 2012, 101:3233-3235.
• [78]Saldana DG, de Acosta DA, Aleman HP, Gebrehiwot D, Torres E: Gallbladder endometrioma associated with obstructive jaundice and a serous ovarian cystic adenoma. South Med J 2010, 103:1250-1252.
• [79]Bailey HR, Ott MT, Hartendorp P: Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum 1994, 37:747-753.
• [80]Gustofson RL, Kim N, Liu S, Stratton P: Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 2006, 86:298-303.
• [81]Jatan AK, Solomon MJ, Young J, Cooper M, Pathma-Nathan N: Laparoscopic management of rectal endometriosis. Dis Colon Rectum 2006, 49:169-174.
• [82]Maroun P, Cooper MJ, Reid GD, Keirse MJ: Relevance of gastrointestinal symptoms in endometriosis. Aust N Z J Obstet Gynaecol 2009, 49:411-414.
• [83]Jerby BL, Kessler H, Falcone T, Milsom JW: Laparoscopic management of colorectal endometriosis. Surg Endosc 1999, 13:1125-1128.
• [84]Maccagnano C, Freschi M, Ghezzi M, Rocchini L, Pellucchi F, Rigatti P, Montorsi F, Colombo R: Kidney endometriosis. Minerva urologica e nefrologica 2013, 65:157-159.
• [85]Gupta K, Rajwanshi A, Srinivasan R: Endometriosis of the kidney: diagnosis by fine-needle aspiration cytology. Diagn Cytopathol 2005, 33:60-61.
• [86]Papakonstantinou E, Orfanos F, Mariolis-Sapsakos T, Vlahodimitropoulos D, Kondi-Pafiti A: A rare case of intrinsic ureteral endometriosis causing hydronephrosis in a 40-year-old woman. A case report and literature review. Clin Exp Obstet Gynecol 2012, 39:265-268.
• [87]Horn LC, Do Minh M, Stolzenburg JU: Intrinsic form of ureteral endometriosis causing ureteral obstruction and partial loss of kidney function. Urol Int 2004, 73:181-184.
• [88]Antonelli A: Urinary tract endometriosis. Urologia 2012, 79:167-170.
• [89]Fambrini M, Andersson KL, Campanacci DA, Vanzi E, Bruni V, Buccoliero AM, Pieralli A, Livi L, Scarselli G: Large-muscle endometriosis involving the adductor tight compartment: case report. J Minim Invasive Gynecol 2010, 17:258-261.
• [90]Kandil E, Alabbas H, Ghafar M, Burris K, Sawas A, Schwartzman A: Endometriosis in the rectus abdominis muscle: case report and literature review. J La State Med Soc 2009, 161:321-324.
• [91]Guida M, Greco E, Di Spiezio Sardo A, Borriello M, Morra I, Nappi C: Isolated extrapelvic endometriosis of the gluteal muscle. J Minim Invasive Gynecol 2009, 16:95-97.
• [92]Floyd JR 2nd, Keeler ER, Euscher ED, McCutcheon IE: Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve. J Neurosurg Spine 2011, 14:281-289.
• [93]Prentice A: Regular review: Endometriosis. BMJ 2001, 323:93-95.
• [94]Attar E, Bulun SE: Aromatase inhibitors: the next generation of therapeutics for endometriosis? Fertil Steril 2006, 85:1307-1318.
• [95]Harada T, Momoeda M, Taketani Y, Hoshiai H, Terakawa N: Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial. Fertil Steril 2008, 90:1583-1588.
• [96]Tesone M, Bilotas M, Baranao RI, Meresman G: The role of GnRH analogues in endometriosis-associated apoptosis and angiogenesis. Gynecol Obstet Invest 2008, 66(Suppl 1):10-18.
• [97]Alkatout I, Mettler L, Beteta C, Hedderich J, Jonat W, Schollmeyer T, Salmassi A: Combined surgical and hormone therapy for endometriosis is the most effective treatment: prospective, randomized, controlled trial. J Minim Invasive Gynecol 2013, 20:473-481.
• [98]Somigliana E, Vercellini P, Vigano P, Benaglia L, Busnelli A, Fedele L: Postoperative medical therapy after surgical treatment of endometriosis: from adjuvant therapy to tertiary prevention. J Minim Invasive Gynecol 2013. doi:10.1016/j.jmig.2013.10.007. [Epub ahead of print]
• [99]Acien P, Velasco I: Endometriosis: a disease that remains enigmatic. ISRN Obstet Gynecol 2013, 2013:242149.
• [100]Bailly E, Margulies AL, Letohic A, Fraleu-Louer B, Renouvel F, Panel P: [Evolution of symptoms and quality of life of patients after surgery of digestive endometriosis]. Gynecol Obstet Fertil 2013, 41(11):627-634. doi:10.1016/j.gyobfe.2013.09.010. Epub 2013 Oct 30