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Naem A, Kouba L, Al-Kurdy B. An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report. Int J Surg Case Rep. 2020;67:130-133doi: 10.1016/j.ijscr.2020.01.045.
Naem, A., Kouba, L., & Al-Kurdy, B. (2020). An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report. International journal of surgery case reports, 67130-133. https://doi.org/10.1016/j.ijscr.2020.01.045
Naem, Antoine, et al. "An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report." International journal of surgery case reports vol. 67 (2020): 130-133. doi: https://doi.org/10.1016/j.ijscr.2020.01.045
Naem A, Kouba L, Al-Kurdy B. An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report. Int J Surg Case Rep. 2020;67:130-133. doi: 10.1016/j.ijscr.2020.01.045. Epub 2020 Feb 06. PMID: 32062117; PMCID: PMC7021526.
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Int J Surg Case Rep. 2020;67:130-133. doi: 10.1016/j.ijscr.2020.01.045. Epub 2020 Feb 06.

An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report.

International journal of surgery case reports

Antoine Naem, Lamia Kouba, Bashar Al-Kurdy

Affiliations

  1. Faculty of Medicine of Damascus University, Damascus, Syria. Electronic address: [email protected].
  2. Faculty of Medicine of Damascus University, Damascus, Syria. Electronic address: [email protected].
  3. Faculty of Medicine of Damascus University, Damascus, Syria; University Hospital of Obstetrics and Gynecology in Damascus, Syria. Electronic address: [email protected].

PMID: 32062117 PMCID: PMC7021526 DOI: 10.1016/j.ijscr.2020.01.045

Abstract

INTRODUCTION: Endometriosis is an estrogen-dependent disease that can provoke fibrosis through the elevated concentration of TGF-β. Endometriosis-related fibrosis often manifests as pelvic adhesions, and it is almost always observed microscopically when examining the endometriotic lesions. Here we are reporting, for the first time in literature, an unusual gross appearance of a serous ovarian cyst that coexisted with endometriosis.

PRESENTATION OF CASE: A 32-year-old G1P2 woman presented to our hospital complaining of the inability to conceive. She was scheduled to have an exploratory laparoscopy. Upon reaching the abdominal cavity, several islands of endometriosis and a left ovarian mass were spotted. The ovarian mass was resected by an excisional biopsy and the pathologic examination showed a benign ovarian cyst with extreme fibrosis in its wall.

DISCUSSION: Endometriosis often induces a chronic pelvic inflammation, mediated mainly by the over-activated macrophages. These cells secrete many cytokines and growth factors that alter the normal pelvic milieu. TGF-β levels are often elevated within the peritoneal fluid, which stimulate fibroblasts and provoke tissue fibrosis. One study suggested that ovarian stromal fibrosis can induce infertility by impairing folliculogenesis. LH-inhibiting regimens can reverse the stromal fibrosis, and improve the fertility outcomes.

CONCLUSION: The mural fibrosis seen in the cystic wall reflects unrecognized ovarian stromal fibrosis induced by the fibrogenic effects of endometriosis. This process may play a potential role in provoking infertility in patients with endometriosis, and could be reversed by administrating the LH-inhibiting regimens.

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Adhesions; Case report; Endometriosis; Fibrosis; Ovarian cyst; Serous cyst

Conflict of interest statement

Declaration of Competing Interest All of the authors declared that they have no conflict of interest.

References

  1. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD004635 - PubMed
  2. Eur J Obstet Gynecol Reprod Biol. 2001 May;96(1):21-34 - PubMed
  3. Int J Surg. 2018 Dec;60:132-136 - PubMed
  4. J Gynecol Obstet Biol Reprod (Paris). 2013 Dec;42(8):786-93 - PubMed
  5. Hum Reprod. 2018 Mar 1;33(3):347-352 - PubMed
  6. Eur J Surg Suppl. 1997;(577):17-23 - PubMed
  7. Obstet Gynecol Clin North Am. 2012 Dec;39(4):535-49 - PubMed
  8. Aging (Albany NY). 2018 Jan 19;10(1):9-10 - PubMed
  9. Semin Diagn Pathol. 2014 Sep;31(5):382-426 - PubMed
  10. Am J Obstet Gynecol. 1987 Apr;156(4):783-9 - PubMed
  11. Fertil Steril. 1978 Jul;30(1):45-9 - PubMed
  12. Am J Obstet Gynecol. 1980 Jun 1;137(3):327-31 - PubMed
  13. Biol Reprod. 1992 Apr;46(4):595-606 - PubMed

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