Extrapelvic Endometriosis: A Systematic Review.
Marina P Andres1, Fernanda V L Arcoverde2, Carolina C C Souza3
1Endometriosis Section, Gynecologic Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (Drs. Andres, Arcoverde, Fernandes, and Abrão); Gynecologic Division, BP-A Beneficencia Portuguesa de São Paulo (Drs. Andres, Souza, Fernandes, and Abrão), São Paulo, Brazil.
Journal of Minimally Invasive Gynecology
|October 17, 2019
Summary
Extrapelvic endometriosis, though rare, is increasingly reported. Prompt diagnosis and a multidisciplinary approach are crucial for managing this condition and improving patient outcomes.
Area of Science:
- Gynecology
- Surgical Oncology
- Radiology
Background:
- Extrapelvic endometriosis, endometriosis outside the pelvic cavity, is an uncommon condition.
- This systematic review examines the literature on extrapelvic endometriosis, focusing on diagnosis and treatment.
Purpose of the Study:
- To systematically review the literature on patients diagnosed with extrapelvic deep endometriosis.
- To consolidate current knowledge on the presentation, diagnosis, and management of extrapelvic endometriosis.
Main Methods:
- A comprehensive literature search was conducted across PubMed/Medline, Embase, and Cochrane databases.
- Included studies published within the last 20 years reporting on primary extrapelvic endometriosis.
- Data extraction and synthesis of findings from 179 included articles, predominantly case reports and series.
Main Results:
- A significant number of extrapelvic endometriosis cases were identified, including parietal (230), visceral (43), thoracic (628), and central nervous system (6) involvement.
- Common symptoms included palpable mass, cyclic pain, and cyclic bleeding, with low preoperative clinical suspicion.
- Surgical excision was the primary treatment, with varying recurrence rates (5% for parietal, 15% for visceral, 29% for thoracic) and low complication rates.
Conclusions:
- Extrapelvic endometriosis, once considered rare, is being reported more frequently.
- Increased clinical awareness, suspicion, and a multidisciplinary approach are essential for timely diagnosis and optimal patient management.
- Further comparative studies are needed to establish evidence-based recommendations for diagnostic methods, treatment strategies, and outcomes.
