Clinic of Gynecology, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy -
Clinic of Gynecology, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
Minerva Obstet Gynecol. 2023 Aug;75(4):387-389. doi: 10.23736/S2724-606X.22.05089-8.
Endometriosis is a benign, estrogen-dependent condition that commonly affects women during the reproductive age. Postmenopausal endometriosis is a rare condition because of the absence of estrogenic hormone production. Furthermore, extrapelvic endometriosis is a rare and complex phenomenon. For this reason, it is usually a misdiagnosed disease. An 84-year-old female patient with no medical history of endometriosis or dysmenorrhea and no hormone replacement therapy was found to have a 4.4×3 cm tender, mobile mass on the left labium majus detached from the underlying perineal muscle. The patient underwent surgical excision under sedation and local anesthesia. The mass was easily removed intact and was not adherent to the vagina or the perineal muscles. Surgical resection of the lesion should be performed in order to remove the lesion and to confirm the diagnosis histologically. The diagnosis of long-standing endometriotic cyst was made. Primary vulvo-perineal endometriosis is a rare and difficult diagnosis especially in postmenopausal women without previous surgical procedures and no history of endometriosis. A better awareness of symptoms and signs of uncommon locations of extrapelvic endometriosis should be encouraged in order to optimize patient care. Finally, more research is needed to elucidate the pathogenesis of endometriosis in postmenopausal women.
子宫内膜异位症是一种良性、雌激素依赖性疾病，常见于育龄妇女。由于缺乏雌激素的产生，绝经后子宫内膜异位症是一种罕见的情况。此外，盆腔外子宫内膜异位症是一种罕见且复杂的现象。因此，它通常是一种误诊疾病。一名 84 岁的女性患者，无子宫内膜异位症或痛经病史，也未接受激素替代治疗，发现左侧大阴唇上有一个 4.4×3 厘米的触痛、可移动的肿块，与下面的会阴肌分离。患者在镇静和局部麻醉下接受了手术切除。肿块很容易完整取出，与阴道或会阴肌肉无粘连。为了切除病变并进行组织学诊断，应进行病变的外科切除。诊断为长期子宫内膜异位囊肿。原发性外阴-会阴子宫内膜异位症是一种罕见且难以诊断的疾病，尤其是在无先前手术且无子宫内膜异位症病史的绝经后妇女中。应该鼓励更好地了解盆腔外子宫内膜异位症罕见部位的症状和体征，以优化患者护理。最后，需要更多的研究来阐明绝经后妇女子宫内膜异位症的发病机制。
