Document Detail

Florid endometriosis in a postmenopausal woman.
MedLine Citation:
PMID:  20537628     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report a case of florid endometriosis.
DESIGN: Case report.
SETTING: University hospital.
PATIENT(S): A 53-year-old postmenopausal woman with a 10-cm retroperitoneal mass comprised of endometriosis causing hydroureteronephrosis and loss of ipsilateral kidney function.
INTERVENTION(S): The patient underwent exploratory laparotomy with extensive lysis of adhesions, right nephrectomy, radical resection of the retroperitoneal mass including partial resection of the psoas muscle, dissection from the inferior vena cava, and resection of distal ileum, cecum, and appendix with a primary ileoascending colon reanastomosis.
MAIN OUTCOME MEASURE(S): Postoperative symptom resolution.
RESULT(S): The patient had widespread adhesive disease with a primary retroperitoneal endometriotic mass and a secondary mass involving the small bowel mesentery. Endometriomas were found in the right kidney and right distal ureter. Additional endometriotic implants were found at the right common iliac bifurcation, appendix, and in multiple mesenteric nodules. No residual ovarian tissue was identified, and preoperative FSH and estrogen (E) levels indicated no evidence of an ovarian remnant.
CONCLUSION(S): Severe endometriosis caused ipsilateral renal failure despite postmenopausal levels of E and FSH, supporting the theory that endometriotic implants may have an autocrine function involving E biosynthesis or may respond to hormone production in adipose tissue.
Amelia P Bailey; Amy K Schutt; Susan C Modesitt
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-05-26
Journal Detail:
Title:  Fertility and sterility     Volume:  94     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-26     Completed Date:  2011-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2769.e1-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22903, USA.
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MeSH Terms
Cecum / pathology,  surgery
Endometriosis / complications,  diagnosis*,  pathology,  surgery
Intestinal Diseases / complications,  diagnosis*,  pathology,  surgery
Intestine, Small / pathology,  surgery
Middle Aged
Nephrosis / diagnosis,  etiology,  pathology,  surgery
Postmenopause* / physiology
Psoas Muscles / pathology,  surgery
Retroperitoneal Space / pathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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