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McCall J, Busca A, Gilbert S, Williams E, Horwood G, Singh SS. Liver endometrioma: a rare extrapelvic site of endometriosis causing catamenial right shoulder pain. Am J Obstet Gynecol 2024; 230:681-682. [PMID: 38307472 DOI: 10.1016/j.ajog.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Affiliation(s)
- Jennifer McCall
- Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada
| | - Aurelia Busca
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada
| | - Sebastien Gilbert
- Division of Thoracic Surgery, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada
| | - Erin Williams
- Division of Thoracic Surgery, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada
| | - Genevieve Horwood
- Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada
| | - Sukhbir S Singh
- Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital & University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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Panackel C, Francis Mathew J, John N, Jacob M. A rare case of mullerianosis of the liver and lung mimicking metastatic biliary cystadenocarcinoma. J R Coll Physicians Edinb 2024:14782715241247244. [PMID: 38660757 DOI: 10.1177/14782715241247244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Anatomically, normal cells found in an abnormal site are known as choristoma. When any two of the three-cell lineage of the mullerian duct, that is endosalpinx, endocervix and endometrium, are found at an abnormal location, it is termed mullerian choristoma or mullerianosis. Mullerianosis histologically reveals glands of varying sizes lined by cervical, tubal and endometrial cells. Individual cell lineages like endometriosis of the ovary, endosalpingiosis and endocervicosis of the urinary bladder are common. But mullerianosis is quite rare, and as per literature, only about 20 cases have been reported. We report a mullerianosis involving the liver and lung in a 41-year-old female that mimicked metastatic biliary cystadenocarcinoma. It is the first case reported in literature where there is simultaneous involvement of the liver and lung by mullerianosis. The diagnosis was made with the help of histopathology and immunohistochemistry in the resected specimens.
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Affiliation(s)
| | | | - Nita John
- Department of Pathology, Lisie Hospital, Kochi, India
| | - Mathew Jacob
- Aster Integrated Liver Care, Aster Medcity, Kochi, KL, India
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Fruchart M, El Idrissi F, Lamer A, Belarbi K, Lemdani M, Zitouni D, Guinhouya BC. Identification of early symptoms of endometriosis through the analysis of online social networks: A social media study. Digit Health 2023; 9:20552076231176114. [PMID: 37228486 PMCID: PMC10204053 DOI: 10.1177/20552076231176114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Endometriosis is a complex full-body inflammation disease with an average time to diagnosis of 7-10 years. Social networks give opportunity to patient to openly discuss about their condition, share experiences, and seek advice. Thus, data from social media may provide insightful data about patient's experience. This study aimed at applying a text-mining approach to online social networks in order to identify early signs associated with endometriosis. Methods An automated exploration technique of online forums was performed to extract posts. After a cleaning step of the built corpus, we retrieved all symptoms evoked by women, and connected them to the MedDRA dictionary. Then, temporal markers allowed targeting only the earliest symptoms. The latter were those evoked near a marker of precocity. A co-occurrence approach was further applied to better account for the context of evocations. Results Results were visualised using the graph-oriented database Neo4j. We collected 7148 discussions threads and 78,905 posts from 10 French forums. We extracted 41 groups of contextualised symptoms, including 20 groups of early symptoms associated with endometriosis. Among these groups of early symptoms, 13 were found to portray already known signs of endometriosis. The remaining 7 clusters of early symptoms were limb oedema, muscle pain, neuralgia, haematuria, vaginal itching, altered general condition (i.e. dizziness, fatigue, nausea) and hot flush. Conclusion We pointed out some additional symptoms of endometriosis qualified as early symptoms, which can serve as a screening tool for prevention and/or treatment purpose. The present findings offer an opportunity for further exploration of early biological processes triggering this disease.
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Affiliation(s)
- Mathilde Fruchart
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
| | - Fatima El Idrissi
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Antoine Lamer
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
| | - Karim Belarbi
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, Lille,
France
| | - Mohamed Lemdani
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Djamel Zitouni
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Benjamin C Guinhouya
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
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4
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da Costa AC, Martins CR, Habib N. Hepatic Endometriosis. J Gastrointest Surg 2022; 26:2396-2398. [PMID: 35819664 DOI: 10.1007/s11605-021-05156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Adriano Carneiro da Costa
- Department of Hepatobiliary Surgery, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK.
| | - Camila Ramos Martins
- Department of Hepatobiliary Surgery, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK
| | - Nagy Habib
- Department of Hepatobiliary Surgery, Hammersmith Hospital, Imperial College London, Du Cane Road, London, W12 0NN, UK.
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Laohawetwanit T, Wanpiyarat N, Lerttanatum N. Useful histopathologic features for diagnosing focal liver lesions with spindle cell morphology: A clinicopathologic study. Ann Diagn Pathol 2022; 59:151975. [DOI: 10.1016/j.anndiagpath.2022.151975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/01/2022]
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Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal. J Clin Med 2022; 11:jcm11040995. [PMID: 35207266 PMCID: PMC8879338 DOI: 10.3390/jcm11040995] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023] Open
Abstract
Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic literature review using the PubMed and Embase databases from 1 January 1950 to 7 February 2021, according to the PRISMA guidelines. The review was registered at PROSPERO (CRD42021239670). Studies were selected if they reported original data on umbilical endometriosis nodule defined at histopathological examination and described as the presence of endometrial glands and/or stromal cells in the connective tissue. A total of 11 studies (10 retrospective and one prospective), and 14 case series were included in the present review. Overall, 232 umbilical endometriosis cases were reported, with the number per study ranging from 1 to 96. Umbilical endometriosis was observed in 76 (20.9%; 95% CI 17.1–25.4) of the women included in studies reporting information on the total number of cases of abdominal wall endometriosis. Umbilical endometriosis was considered a primary form in 68.4% (158/231, 95% CI 62.1–74.1) of cases. A history of endometriosis and previous abdominal surgery were reported in 37.9% (25/66, 95% CI 27.2–49.9) and 31.0% (72/232, 95% CI 25.4–37.3) of cases, respectively. Pain was described in 83% of the women (137/165, 95% CI 76.6–88.0), followed by catamenial symptoms in 83.5% (142/170, 95% CI, 77.2–88.4) and bleeding in 50.9% (89/175, 95% CI 43.5–58.2). In the 148 women followed for a period ranging from three to 92.5 months, seven (4.7%, 95% CI 2.3–9.4) recurrences were observed. The results of this analysis show that umbilical endometriosis represents about 20% of all the abdominal wall endometriotic lesions and that over two thirds of cases are primary umbilical endometriosis forms. Pain and catamenial symptoms are the most common complaints that suggest the diagnosis. Primary umbilical endometriosis may originate from implantation of regurgitated endometrial cells conveyed by the clockwise peritoneal circulation up to the right hemidiaphragm and funneled toward the umbilicus by the falciform and round liver ligaments.
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El Idrissi F, Fruchart M, Belarbi K, Lamer A, Dubois-Deruy E, Lemdani M, N’Guessan AL, Guinhouya BC, Zitouni D. Exploration of the core protein network under endometriosis symptomatology using a computational approach. Front Endocrinol (Lausanne) 2022; 13:869053. [PMID: 36120440 PMCID: PMC9478376 DOI: 10.3389/fendo.2022.869053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Endometriosis is defined by implantation and invasive growth of endometrial tissue in extra-uterine locations causing heterogeneous symptoms, and a unique clinical picture for each patient. Understanding the complex biological mechanisms underlying these symptoms and the protein networks involved may be useful for early diagnosis and identification of pharmacological targets. METHODS In the present study, we combined three approaches (i) a text-mining analysis to perform a systematic search of proteins over existing literature, (ii) a functional enrichment analysis to identify the biological pathways in which proteins are most involved, and (iii) a protein-protein interaction (PPI) network to identify which proteins modulate the most strongly the symptomatology of endometriosis. RESULTS Two hundred seventy-eight proteins associated with endometriosis symptomatology in the scientific literature were extracted. Thirty-five proteins were selected according to degree and betweenness scores criteria. The most enriched biological pathways associated with these symptoms were (i) Interleukin-4 and Interleukin-13 signaling (p = 1.11 x 10-16), (ii) Signaling by Interleukins (p = 1.11 x 10-16), (iii) Cytokine signaling in Immune system (p = 1.11 x 10-16), and (iv) Interleukin-10 signaling (p = 5.66 x 10-15). CONCLUSION Our study identified some key proteins with the ability to modulate endometriosis symptomatology. Our findings indicate that both pro- and anti-inflammatory biological pathways may play important roles in the symptomatology of endometriosis. This approach represents a genuine systemic method that may complement traditional experimental studies. The current data can be used to identify promising biomarkers for early diagnosis and potential therapeutic targets.
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Affiliation(s)
- Fatima El Idrissi
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Mathilde Fruchart
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
| | - Karim Belarbi
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, Lille, France
| | - Antoine Lamer
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
| | - Emilie Dubois-Deruy
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Mohamed Lemdani
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
| | - Assi L. N’Guessan
- Univ. Lille, UMR CNRS 8524, Laboratoire Paul Painlevé, Villeneuve d’Ascq, Cedex, France
| | - Benjamin C. Guinhouya
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
- *Correspondence: Benjamin C. Guinhouya,
| | - Djamel Zitouni
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
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Wang D, Yang Q, Wang H, Liu C. Malignant transformation of hepatic endometriosis: a case report and literature review. BMC WOMENS HEALTH 2021; 21:249. [PMID: 34154577 PMCID: PMC8218461 DOI: 10.1186/s12905-021-01366-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/19/2021] [Indexed: 11/22/2022]
Abstract
Background Extrapelvic endometriosis is defined as the presence of ectopic endometrial tissue in structures outside the pelvis. Although extra-pelvic endometriosis is generally considered benign conditions, malignant potential within endometriotic foci occurs even after definitive surgery. Malignant transformation of hepatic endometriosis is extremely rare. Preoperative diagnosis of this cancer is difficult, and no guidelines on the optimal management currently exist. Here, we present a case report of malignant transformation of hepatic endometriosis and a brief literature review to highlight the current knowledge of the prevalence, clinical features, diagnosis, and management of this condition. Case presentation A 50-year-old woman with a 2-year duration of progressive right upper quadrant abdominal pain was admitted to the hospital. She underwent hysterectomy and bilateral salpingo-oophorectomy for benign conditions 4 years prior. Tumor markers demonstrated elevated carbohydrate antigen (CA)-199 112U/mL (normal range: 0–35U/mL) only. Radiological imaging suggested the presence of a 10.7 × 7.7-cm mass in the right lobe of the liver extending to the diaphragm. The intraoperative frozen sections suggested malignant tumor. Right hepatectomy with infiltrating diaphragm resection was performed. The final pathology with immunohistochemistry staining confirmed endometrioid adenocarcinoma in the liver originating from preexisting hepatic endometriosis. After the multidisciplinary team meeting, the consensus was surgery followed by adjuvant chemotherapy. To our knowledge, this is the first case of Chinese woman of a malignant liver tumor originating from endometriosis ever reported by reviewing the current English medical literature. Conclusion Though rare, extrapelvic endometriosis-associated cancers should be considered as differentiated diagnosis even after hysterectomy and bilateral salpingo-oophorectomy. This case highlights the importance of collaborative efforts across multiple disciplines for accurate diagnosis and appropriate treatment of malignant transformation of hepatic endometriosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01366-6.
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Affiliation(s)
- Dandan Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China
| | - Qing Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China
| | - Huaitao Wang
- Department of Pancreas and Thyroid Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China
| | - Chang Liu
- Department of Pathology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China.
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An unexpected liver lesion? Acta Gastroenterol Belg 2021; 84:385-386. [PMID: 34217196 DOI: 10.51821/84.2.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A 50-year-old woman presented with pain in her right upper abdomen. In her medical history we note a Caesarean section and a laparotomy with bilateral ovariectomy because of benign cysts. The liver enzymes were mildly elevated: aspartate transaminase 40 U/l (reference < 32 U/l), alanine transaminase 53 U/l (reference < 31 U/l), gamma-glutamyl transferase 97 U/l (reference 5 – 36). Computed tomography (CT) revealed a large lesion in the right liver lobe with a cyst within cyst appearance and with important compression of the surrounding tissue (figure 1, panel A). The total diameter measured 29 cm by 17 cm by 22 cm.
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Abstract
Endometriosis is a relatively common condition in which endometrial tissue is established in locations outside the uterus where, like the eutopic endometrium, it responds to hormonal stimuli and develops internal bleeding, inflammation, and fibrosis. These changes are associated with chronic and often debilitating cyclic pain and infertility. The pathogenesis of endometriosis is multifactorial, and several theories have been proposed to explain it. These include retrograde menstruation, celomic metaplasia, embryologic rests, and lymphovascular spread. Hormones, immunologic status, and genetic factors may also play a role. In most patients, the disease involves pelvic organs, but rarely it may also extend to a large variety of distant locations in the body. Patients with ovarian endometriosis are at higher risk for developing ovarian carcinomas including endometrioid and clear cell carcinomas. Some of these carcinomas may arise in a background of structural and/or nuclear atypia within the endometriotic foci. There is no known cure for endometriosis and treatment mostly consists of managing chronic pain or infertility.
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Affiliation(s)
- Maria Arafah
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Sameera Rashid
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Akhtar
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
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Prodromidou A, Pandraklakis A, Rodolakis A, Thomakos N. Endometriosis of the Canal of Nuck: A Systematic Review of the Literature. Diagnostics (Basel) 2020; 11:diagnostics11010003. [PMID: 33375037 PMCID: PMC7821999 DOI: 10.3390/diagnostics11010003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is a common benign gynecological condition defined as the presence of endometrial tissue in tissues outside the uterine cavity. Apart from the common sites of endometriosis, rare sites other have also been reported including the liver, the thoracic cavity, the muscles, nerves, and more rarely in a patent Nuck canal. We aim to evaluate the clinical presentation, diagnostic features, and management of the Nuck endometriosis. A meticulous search of three electronic databases was performed until May 2020 for articles reporting cases of Nuck endometriosis. A total of 36 patients from 20 studies were analyzed. Median age of patients was 36 years with 33 women being of reproductive age. A right-sided lesion was identified in 30 cases (83.3%), while all patients suffer from a groin mass with cyclic pain in a proportion of 22%. All the patients finally underwent surgery for investigation of the lesion and fixation of the defect. Five cases of malignancy were detected at final pathology. All of them were alive with a median reported overall survival of 37 months. Nuck endometriosis should be included in the differential diagnosis of female patients with groin swelling. An evaluation by a gynecologist is important when endometriosis is suspected.
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