Etiopathogenicity and diagnosis of endometrial ovarian tumors

Abstract

Introduction. Endometriosis is a benign gynecological estrogen-dependent disease characterized by endometrium-like tissue outside the uterus. The disease affects approx. 6-10% of women of reproductive age. The benign endometrial tumor also known as ’’chocolate cyst” affects 17-44% of women with endometriosis. Etiological theories explaining the endometrial lesions are: reflux of endometrial tissue via fallopian tubes during menstruation, coelomic metaplasia, vestiges of embryonic cells and lymphatic and vascular proliferation. The golden standard in diagnosis of endometrial tumors is laparoscopy. Transvaginal ultrasound does not help in initial diagnosis, but nonetheless can help in telling apart the endometrial from other benign ovarian tumors, while MRI helps in differentiating endometrial ovarian tumors from other ovarian cysts. Aim of the study. Evaluation of risk factors and methods of diagnosis of endometrial ovarian tumors. Materials and methods.. Lot of patients: 27 patients with endometrial ovarian tumors who were hospitalized and received treatment at PMSI OI of the Republic of Moldova between 2014 and 2019. Results. Total number of patients enrolled in the study: 27 patients, 25-45 years (age of highest incidence) - 15 patients (55,5%). The most frequent symptoms: pelvic pain - 27 patients (100%), dysmenorrhea - 9 patients (33,3%), dyspareunia- 5 patients (18,51%), metrorrhagia - 3 patients (11,1%).Bimanual examination of 12 patients (44,4%), revealed a smooth, elastic mass. According to laboratory data, 19 patients (70,37%) showed high CA 125 values, and 14 patients (51,8%) high estradiol values. Diagnostic imaging: ultrasound - 27 patients (100%), CT -7 patients (25,92%), MRI - 3 patients (11,1%). Laparoscopic methods: diagnostic laparoscopy - 12 patients (44,4%). All patients have received surgical treatment: surgery under laparoscopy - 12 patients (44,4%), laparotomy - 15 patients (55,5%). Conclusions. 1.Age and high estrogen levels are among the main factors which lead to endometrial ovarian tumors. 2.Pelvic pain is the main symptom shown by patients followed by dysmenorrhea, dyspareunia, and metrorrhagia. 3.Laparoscopy is the golden standard in the diagnosis of endometrial ovarian tumors.