Recently I've experienced strange finding in hysterectomy specimen with multiple myomas and adenomyosis and endometriosis in the serosal surface. Several clusters of endometrial tissue was found in the parametrial blood vessels and attached to the vessel lumen which doesn't seem to be just tissue contamination. What do I have to consider in this lesion?
I think blood vessels invasion can justify endometriosis dissemination to far place once into the vessels endometriosis focuses would make liberation of endometrial cells. I also think these finding could be responsible by greater bleending in surgical act.
This all are only options since I never experienced similar situation
I think this is the Dissemination of Endometriosis on the serosal surface,i have come across such condition. Bleeding and the Adhesions is the surgical diffculties in these cases.even in the fibroids also we may get Leiomyomatous Dissemination in some cases though rare.
Endometriosis can spread via blood and lymphatic vessels. This underestimated fact can explain several rare symptoms or histopathological findings, e.g. endometriosis within the sciatic nerve or endometriosis at very distant localisations. Please, see also: Tempfer CB et al. Lymphatic spread of endometriosis to pelvic sentinel lymph nodes: a prospective clinical study. Fertil Steril. 2011 Sep;96(3):692-6. doi: 10.1016/j.fertnstert.2011.06.070 or Zamurovic M. Rare extrapelvic endometriosis on iliac vein wall--diagnosis and treatment. Clin Exp Obstet Gynecol. 2014;41(3):349-50.
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