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Trachsel B, Imobersteg S, Valpreda G, Singer G, Grabherr R, Ormos M, Burger IA, Kubik-Huch RA, Schibli R, Vogel V, Béhé M. Relaxed fibronectin: a potential novel target for imaging endometriotic lesions. EJNMMI Res 2024; 14:17. [PMID: 38340184 DOI: 10.1186/s13550-024-01070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Endometriosis is characterized by the ectopic occurrence of endometrial tissue. Though considered benign, endometriotic lesions possess tumor-like properties such as tissue invasion and remodeling of the extracellular matrix. One major clinical hurdle concerning endometriosis is its diagnosis. The diagnostic modalities ultrasound and MRI are often unable to detect all lesions, and a clear correlation between imaging and clinical symptoms is still controversial. Therefore, it was our aim to identify a potential target to image active endometriotic lesions. RESULTS For our studies, we employed the preclinical radiotracer [111In]In-FnBPA5, which specifically binds to relaxed fibronectin-an extracellular matrix protein with key functions in homeostasis that has been implicated in the pathogenesis of diseases such as cancer and fibrosis. We employed this tracer in biodistribution as well as SPECT/CT studies in mice and conducted immunohistochemical stainings on mouse uterine tissue as well as on patient-derived endometriosis tissue. In biodistribution and SPECT/CT studies using the radiotracer [111In]In-FnBPA5, we found that radiotracer uptake in the myometrium varies with the estrous cycle of the mouse, leading to higher uptake of [111In]In-FnBPA5 during estrogen-dependent phases, which indicates an increased abundance of relaxed fibronectin when estrogen levels are high. Finally, immunohistochemical analysis of patient samples demonstrated that there is preferential relaxation of fibronectin in the proximity of the endometriotic stroma. CONCLUSION Estrous cycle stages characterized by high estrogen levels result in a higher abundance of relaxed fibronectin in the murine myometrium. This finding together with a first proof-of-concept study employing human endometriosis tissues suggests that relaxed fibronectin could be a potential target for the development of a diagnostic radiotracer targeting endometriotic lesions. With [111In]In-FnBPA5, the matching targeting molecule is in preclinical development.
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Affiliation(s)
- Belinda Trachsel
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Stefan Imobersteg
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
| | - Giulia Valpreda
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Gad Singer
- Kantonsspital Baden, 5404, Baden, Switzerland
| | | | - Mark Ormos
- Kantonsspital Baden, 5404, Baden, Switzerland
| | | | | | - Roger Schibli
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Viola Vogel
- Laboratory of Applied Mechanobiology, Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zurich, 8093, Zurich, Switzerland
| | - Martin Béhé
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland.
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Wang Y, Dong A, Cai M. Intense FDG Uptake in Leiomyomatosis Peritonealis Disseminata With Fumarate Hydratase Deficiency. Clin Nucl Med 2024; 49:e93-e95. [PMID: 38170909 DOI: 10.1097/rlu.0000000000005012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
ABSTRACT A 35-year-old woman with a history of laparoscopic myomectomy presented with repeated abdominal pain. Contrast-enhanced abdominal and pelvic CT showed multiple enhancing solid or mixed cystic and solid peritoneal masses, and an enhancing uterine mass. All these masses showed intense FDG uptake on FDG PET/CT. The intraperitoneal and uterine masses were surgically removed. The histological and immunohistochemical findings of the peritoneal lesions were consistent with leiomyomatosis peritonealis disseminata with fumarate hydratase deficiency, and the uterine mass was adenomyosis. This case indicates fumarate hydratase-deficient extrauterine leiomyoma can show intense FDG uptake mimicking malignancy.
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Affiliation(s)
- Yang Wang
- From the Department of Pathology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine
| | - Aisheng Dong
- Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University
| | - Meiling Cai
- Department of Obstetrics and Gynecology, Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
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Padilla Bermejo A, García Zoghby L, Pena Pardo FJ, Del Prado Talavera Rubio M, Poblete García VM. 18 F-FDG PET/CT to Spare Malignancy in a Rare Case of Lung Endometriosis. Clin Nucl Med 2023; 48:e472-e473. [PMID: 37586103 DOI: 10.1097/rlu.0000000000004787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
ABSTRACT Lung endometriosis is a rare condition. A 44-year-old woman with known lung endometriosis and radiological follow-up showed progression of bilateral lung affection at control CT, with an enlarged solid nodule with respect to previous control. 18 F-FDG PET/CT was performed to assess that lesion and to guide biopsy. PET images showed the multiple known nodules with pathological tracer uptake.
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Affiliation(s)
- Amanda Padilla Bermejo
- From the Nuclear Medicine Department, Ciudad Real University General Hospital, Ciudad Real, Spain
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Balogova S, Daraï E, Noskovicova L, Lukac L, Talbot JN, Montravers F. Interference of Known or Suspected Endometriosis in Reporting FDG PET/CT Performed in Another Indication. Clin Nucl Med 2022; 47:305-313. [PMID: 35119396 PMCID: PMC8884178 DOI: 10.1097/rlu.0000000000004049] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/03/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Endometriosis is a common gynecologic condition that may be visualized on 18F-FDG PET/CT and mimic lesions of malignancy. We analyzed the interference of known or suspected endometriosis in reporting 18F-FDG PET/CT performed in another indication. RESULTS The PET/CT images of 18 women with known (n = 15) or suspected (n = 3) endometriosis were analyzed. Based on clinical follow-up and results of other imaging, biopsy, and/or postsurgical histology, the presence of lesions of endometriosis at the time of 18F-FDG PET/CT was confirmed in 13 of 18 patients (72%). The per-patient positivity rate of 18F-FDG PET/CT was 8/18 (44%; 95% confidence interval, 22%-69%). The patient-based detection rate of 18F-FDG PET/CT in patients with confirmed lesions of endometriosis was 8/13 (62%; confidence interval, 32%-86%). On per-lesion/site basis, 18F-FDG PET/CT detected 11 of 20 sites (55%) of endometriosis. The SUVmax of these lesions/sites ranged between 1.8 and 5.3 (median, 3.8). In 9 of 18 patients (50%), a total of 13 non-endometriosis-related lesions/sites were detected by 18F-FDG PET/CT; their SUVmax ranged between 2.7 and 23 (median, 9.4). CONCLUSION The interference of known or suspected endometriosis in reporting 18F-FDG PET/CT performed in another indication was limited but possible and should be kept in mind, even in postmenopausal women, as the oldest patient with 18F-FDG-positive endometriosis was aged 63 years. The lesions of endometriosis showed inconstant 18F-FDG uptake with overlap of SUVmax with low-grade malignancies. In our series, the greatest SUVmax value of lesion of endometriosis was 5.3, somewhat higher than the threshold of 4 previously proposed for identification of malignant transformation of endometriosis.
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Affiliation(s)
- Sona Balogova
- From the Nuclear Medicine, GH Tenon-St Antoine and Sorbonne University, Assistance Publique des Hôpitaux de Paris, Paris, France
- Department of Nuclear medicine of Comenius University and St Elisabeth Oncology Institute, Bratislava, Slovakia
| | - Emile Daraï
- Department of Gynecology and Obstetrics, Tenon Hospital, Sorbonne University, Assistance Publique des Hôpitaux de Paris
- French National Cancer Associé à La Grossesse (CALG) Network, Sorbonne University, Assistance Publique des Hôpitaux de Paris Tenon
- INSERM U938, IUC-UPMC, Sorbonne University, Paris, France
| | - Lucia Noskovicova
- Department of Nuclear medicine of Comenius University and St Elisabeth Oncology Institute, Bratislava, Slovakia
| | - Ludovit Lukac
- First Department of Internal Medicine of Comenius University and University Hospital of Bratislava, Bratislava, Slovakia
| | - Jean-Noël Talbot
- From the Nuclear Medicine, GH Tenon-St Antoine and Sorbonne University, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Françoise Montravers
- From the Nuclear Medicine, GH Tenon-St Antoine and Sorbonne University, Assistance Publique des Hôpitaux de Paris, Paris, France
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Mulette P, Jacquet A, Durlach A, Papathanassiou D, Lalire P, Graesslin O, Delepine G, Dury S, Dormoy V, Perotin JM, Lebargy F, Deslée G, Launois C. Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis: A case report. Medicine (Baltimore) 2021; 100:e27550. [PMID: 34678890 PMCID: PMC8542117 DOI: 10.1097/md.0000000000027550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/13/2021] [Accepted: 10/01/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Thoracic endometriosis is a rare disorder that can involve airways, pleura and lung parenchyma. It is the most frequent form of extra-abdominopelvic endometriosis. Multiple lung cavitations are a rare feature of thoracic endometriosis. PATIENT CONCERNS A 46-year-old woman was referred to our hospital after incidental finding of multiple pulmonary cavitations with surrounding areas of ground glass opacity on a thoraco-abdominal computed tomography-scan performed for abdominal pain. Retrospectively, the patient also reported mild hemoptysis occurring 4 months ago. DIAGNOSES Positron emission tomography-computed tomography scan revealed moderate and homogeneous [18F] fluoro-2-deoxy-D-glucose (18F-FDG) uptake in pulmonary cavitations (maximum standardized uptake value 5.7). The diagnosis of thoracic endometriosis was confirmed by histological examination of surgical resection of a left lower lobe cavitation. INTERVENTIONS AND OUTCOME Gonadotropin-releasing hormone analogues associated with add-back therapy was started. Four months after initiating pharmacological treatment, the chest computed tomography-scan showed a dramatic decrease in lung cavitations size. LESSONS Thoracic endometriosis is a rare disorder requiring a multidisciplinary management including gynaecologist, pulmonologist, radiologist, nuclear physician, pathologist and thoracic surgeon for early diagnosis and treatment. Our case report highlights that an increased 18F-FDG uptake can be found in thoracic endometriosis syndrome presenting as multiple lung cavitations.
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Affiliation(s)
- Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Amaury Jacquet
- Department of Pathology, Reims University Hospital, France
| | - Anne Durlach
- Department of Pathology, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Dimitri Papathanassiou
- Department of Nuclear Medicine, Jean Godinot Institute, Reims, France
- Laboratory of Biophysics, Research Unit of Medicine, University of Reims Champagne-Ardenne, Reims, France
- Science and Information Technology Research Center (CReSTIC) EA 3804, University of Reims Champagne-Ardenne, Reims, France
| | - Paul Lalire
- Department of Nuclear Medicine, Jean Godinot Institute, Reims, France
| | - Olivier Graesslin
- Department of Obstetrics and Gynecology, Reims University Hospital, France
| | - Gonzague Delepine
- Department of Cardiothoracic Surgery, Reims University Hospital, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Valérian Dormoy
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, France
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Abstract
The role of hybrid imaging with 2-[18F] flourodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) is continuously evolving and now considered standard practice in evaluation of disease stage, treatment response, recurrent disease and follow-up for numerous primary malignancies. In gynecological malignancies FDG PET/CT plays an important role, not only in the assessment of disease in the pre-and post-therapy setting, but also in radiation therapy (RT) planning by defining the metabolically active gross tumor volume (GTV. The glucose analogue radiotracer, FDG, is by far the most utilized radiotracer in PET/CT and is typically seen with high uptake in malignant cells. The radiotracer FDG has a high sensitivity but low specificity for malignancy, as benign processes with an inflammatory response for example infection, are also FDG-avid. In the evaluation of the female pelvic region an awareness of potential confounding factors in the interpretation of FDG is essential as variations of FDG uptake occur in accordance with the menstrual cycle and the menopausal state. Incidental imaging findings in the female genital can pose differential diagnostic challenges as false-positive and false-negative findings in benign and malignant processes are not uncommon. Gynecological malignancies continue to pose major public health problems with cervical cancer as the fourth most common cancer in women ranking after breast cancer, colorectal cancer and lung cancer. Familiarity with frequently encountered benign and malignant variants and pitfalls in FDG PET/CT in the female pelvic region can aid the reader in differential diagnostic considerations.
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Affiliation(s)
- Danijela Dejanovic
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Naja Liv Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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7
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Extrapelvic Endometriosis: A Systematic Review. J Minim Invasive Gynecol 2020; 27:373-389. [DOI: 10.1016/j.jmig.2019.10.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/23/2019] [Accepted: 10/06/2019] [Indexed: 02/08/2023]
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8
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Value of the 68 Ga-DOTATATE PET-CT in the diagnosis of endometriosis. A pilot study. Eur J Obstet Gynecol Reprod Biol 2017; 212:69-74. [DOI: 10.1016/j.ejogrb.2017.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 11/17/2022]
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9
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Maffione AM, Panzavolta R, Lisato LC, Ballotta M, D'Isanto MZ, Rubello D. Retroperitoneal Endometriosis: A Possible Cause of False Positive Finding at (18)F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. World J Nucl Med 2015; 14:131-3. [PMID: 26097425 PMCID: PMC4455170 DOI: 10.4103/1450-1147.154230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Endometriosis is a frequent and clinically relevant problem in young women. Laparoscopy is still the gold standard for the diagnosis of endometriosis, but frequently both morphologic and functional imaging techniques are involved in the diagnostic course before achieving a conclusive diagnosis. We present a case of a patient affected by infiltrating retroperitoneal endometriosis falsely interpreted as a malignant mass by contrast-enhanced magnetic resonance imaging and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.
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Affiliation(s)
| | - Riccardo Panzavolta
- Department of Radiology, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | | | - Maria Ballotta
- Department of Pathology, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | | | - Domenico Rubello
- Department of Nuclear Medicine, Santa Maria Della Misericordia Hospital, Rovigo, Italy
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10
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A rare presentation of catamenial hemoptysis as a solitary pulmonary nodule. Emerg Radiol 2014; 22:207-9. [DOI: 10.1007/s10140-014-1267-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022]
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18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography-Positive Lymph Node Endometriosis Masquerading as Lymph Node Metastasis of a Malignant Tumor. Case Rep Obstet Gynecol 2014; 2014:648485. [PMID: 25180115 PMCID: PMC4142537 DOI: 10.1155/2014/648485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/31/2014] [Indexed: 11/18/2022] Open
Abstract
Endometriosis is defined as the presence of endometrium-like tissues at extrauterine sites, most commonly in the abdominal cavity. Lymph node endometriosis is a rare but clinically important type of endometriosis that can mimic lymph node metastasis of a malignant tumor.18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a useful tool for diagnosing malignant tumors, although it occasionally shows false positive results in tissues with high metabolic activity caused by severe inflammation. In the present report, we describe a case of lymph node endometriosis that mimicked lymph node metastasis of a malignant tumor and showed a positive result on18F-FDG PET/CT. The findings of the present case suggest that lymph node endometriosis could present as swollen lymph nodes with18F-FDG PET/CT-positive results and provide important information for determining an appropriate treatment strategy.
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12
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Schwager K, Bootz F, Imesch P, Kaspar M, Trachsel E, Neri D. The antibody-mediated targeted delivery of interleukin-10 inhibits endometriosis in a syngeneic mouse model. Hum Reprod 2011; 26:2344-52. [PMID: 21705369 DOI: 10.1093/humrep/der195] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Endometriosis is still a highly underdiagnosed disease, and the current medical and surgical treatment of endometriosis is associated with a high recurrence rate. This study investigates the use of derivatives of the human antibody F8, specific to the alternatively spliced extra-domain A of fibronectin (Fn), for the imaging and treatment of endometriosis. METHODS Immunohistochemistry and immunofluorescence was used to evaluate antigen expression in endometriotic tissue of human endometriosis and of a syngeneic mouse model of the disease. The in vivo targeting performance of a fluorescent derivative of the F8 antibody was assessed by imaging mice with endometriosis using a near-infrared fluorescence imager, 24 h following i.v. injection of the antibody conjugate. Furthermore, the mouse model was used for therapy experiments using two recombinant F8-based immunocytokines [F8-interleukin-10 (IL10) and F8-IL2] or saline for the treatment groups. RESULTS A very strong vascular expression of splice isoforms of Fn and of tenascin-C was observed in human endometriotic lesions by immunohistochemistry and immunofluorescence techniques. After i.v. administration, a selective accumulation of the F8 antibody in endometriotic lesions could be observed in a syngeneic mouse model. These targeting data were used as a basis for therapy experiments with a pro-inflammatory (F8-IL2) and an anti-inflammatory (F8-IL10) cytokine fusion protein of the F8 antibody. The average lesion size in the F8-IL10 treatment group was clearly reduced compared with the saline control group and with the F8-IL2 group, for which no therapeutic effects were observed. CONCLUSIONS The F8 antibody targets endometriotic lesions in vivo in a mouse model of endometriosis and may be used for the non-invasive imaging of the disease and for the pharmacodelivery of anti-inflammatory cytokines, such as IL10.
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Affiliation(s)
- Kathrin Schwager
- Philochem AG, c/o ETH Zurich, Institute of Pharmaceutical Sciences, Wolfgang-Pauli-Str. 10 HCI E520, CH-8093 Zurich, Switzerland
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Fastrez M, Nogarède C, Tondeur M, Sirtaine N, Rozenberg S. Evaluation of 18FDG PET-CT in the Diagnosis of Endometriosis. Reprod Sci 2011; 18:540-4. [DOI: 10.1177/1933719110392060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Maxime Fastrez
- Department of Obstetrics and Gynaecology, CHU St Pierre, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - C. Nogarède
- Department of Nuclear Medicine, CHU St Pierre, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - M. Tondeur
- Department of Nuclear Medicine, CHU St Pierre, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - N. Sirtaine
- Department of Pathology, CHU St Pierre & Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - S. Rozenberg
- Department of Obstetrics and Gynaecology, CHU St Pierre, Université Libre de Bruxelles, 1000 Brussels, Belgium
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Setubal A, Maia S, Lowenthal C, Sidiropoulou Z. FDG-PET value in deep endometriosis. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s10397-010-0652-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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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; 17:258-61. [PMID: 20226421 DOI: 10.1016/j.jmig.2009.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 09/15/2009] [Accepted: 12/04/2009] [Indexed: 11/26/2022]
Abstract
Extrapelvic endometriosis is an uncommon condition but can involve nearly every organ, resulting in a wide range of clinical manifestations. Herein, we describe the case of a 45-year-old woman not a candidate for hormonal therapy who had cyclic pain in the left thigh associated with progressive impairment of walking ability. Clinical, instrumental, and laboratory data supported the diagnosis of endometriosis involving the adductor muscles compartment associated with ovarian endometriomas. Laparoscopic bilateral salpingo-oophorectomy and local wide excision in collaboration with an experienced orthopedic oncologist were performed, and definitive histologic analysis confirmed the diagnosis of endometriosis. The patient was pain-free at 6-month follow-up and demonstrated substantial improvement in ambulation and quality of life. Large-muscle endometriosis is a rare entity that can compromise musculoskeletal integrity and decrease quality of life. In this case, surgical excision in collaboration with an orthopedic oncologist was the cornerstone of treatment.
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Affiliation(s)
- Massimiliano Fambrini
- Department of Gynecology, Perinatology, and Human Reproduction, University of Florence, Florence, Italy.
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