Laufer M R, Heerema A E, Parsons K E, Barbieri R L
Division of Gynecology, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA.
Gynecol Obstet Invest. 1998;46(3):195-8. doi: 10.1159/000010032.
To define the clinical presentation and follow-up of women found to have endosalpingiosis.
Subjects included for retrospective study were identified as having had a pathologic diagnosis of endosalpingiosis. Those subjects without coinciding pathologic diagnosis of endometriosis were then identified; their clinical charts were reviewed for information regarding the clinical presentation, surgical findings, therapeutic management, and clinical follow-up.
Review of 1,648 pathologic reports from Children's Hospital, Boston and 380 reports from Brigham and Women's Hospital identified 18 subjects with endosalpingiosis without pathologic evidence of endometriosis. Two clinical scenarios were identified, and designated Groups I and II. Group I consisted of 15 patients presenting with pelvic pain, and Group II consisted of 3 patients presenting with infertility, pancreatic cancer, and an abdominal abscess. Follow-up was obtained for 8 of the 15 patients in Group I for an average of 17 months, none of whom were pain-free off medications (oral contraceptives, danazol, or GnRH agonist), and 3 (38%) have required additional surgery (6, 10 or 12 months after the initial surgery) at which time all were found to have endometriosis. Follow-up was obtainable for the patient with infertility in Group II for 5 months, with no complaint of pelvic pain.
We report 18 patients with endosalpingiosis without confounding endometriosis. The clinical presentation is one of either pelvic pain or that of an incidental finding; the clinical course and response of those with pain is similar to that of endometriosis.
明确患有输卵管内膜异位症女性的临床表现及随访情况。
纳入回顾性研究的对象为经病理诊断患有输卵管内膜异位症者。然后确定那些无子宫内膜异位症病理诊断相符的对象;查阅其临床病历,获取有关临床表现、手术发现、治疗处理及临床随访的信息。
回顾波士顿儿童医院的1648份病理报告及布里格姆妇女医院的380份报告,确定18例患有输卵管内膜异位症且无子宫内膜异位症病理证据的患者。确定了两种临床情况,分别指定为I组和II组。I组由15例出现盆腔疼痛的患者组成,II组由3例分别出现不孕、胰腺癌及腹部脓肿的患者组成。I组15例患者中的8例获得了随访,平均随访17个月,无一例在停用药物(口服避孕药、达那唑或促性腺激素释放激素激动剂)后无痛,3例(38%)需要再次手术(初次手术后6、10或12个月),此时发现均患有子宫内膜异位症。II组不孕患者获得了5个月的随访,无盆腔疼痛主诉。
我们报告了18例无混淆性子宫内膜异位症的输卵管内膜异位症患者。临床表现为盆腔疼痛或偶然发现;有疼痛症状者的临床病程及反应与子宫内膜异位症相似。