Rupture of ovarian endometriotic cyst complicated with endometriosis:A case report

BACKGROUND Endometriosis(EMs),an estrogen-dependent disease,refers to the appearance of mucosa-covered endometrial tissues(glandular and interstitial)growing in the uterine cavity outside the uterine myometrium.It is commonly seen in women aged 25 to 45,with an incidence of approximately 10%-15%.CASE SUMMARY A 35-year-old unmarried female who denied a history of sex with an intact hymen had multiple dysmenorrhea and pain in the left lower abdomen that recurred during menstruation.Ultrasound examination revealed a dark cystic area measuring 4.9 cm×4.6 cm on the left side with poor light transmittance,which suggested a left endometriotic cyst.The patient was treated with pain medications(four capsules t.i.d.,p.o.).After one month,computed tomography of the abdomen and pelvis revealed a low-density focus measuring approximately 38 mm in diameter,a blurred mesentery fat plane in the pelvic cavity,and pelvic effusion.Ultrasound showed a complex echo density measuring 5.2 cm×3.0 cm×4.2 cm in the left ovarian area and a fluid sonolucent area with a depth of 2.0 cm in the pelvic cavity.Left ovarian cystectomy,electrocautery for endometriotic lesions,myomectomy,and pelvic adhesion lysis were performed under laparoscopy.The postoperative diagnosis was left ovarian chocolate cyst rupture and EMs(stage III,ovarian type,peritoneal type).CONCLUSION Laparoscopic surgery can safely control the symptoms of EMs and effectively eradicate the disease.

Intracystic hemorrhage in a non-endometriotic mullerian vaginal cyst

The commonest type of simple vaginal cyst is the Mullerian cyst. These are typically lined by columnar epithelium and contain serous or mucinous f luid. If blood is found in the cyst, the source is usually due to the presence of endometrial elements in the cyst wall. The cyst is then termed an endometriotic cyst. In this case report, we have described a woman with a symptomatic 3 cm upper vaginal cyst who underwent surgical excision of the cyst. The cyst cavity was found to be full of old dark blood and mucous, however the wall contained no endometrial tissue and was lined by columnar epithelium which stained positive for mucous with mucicarmine. No cause for the intracystic hemorrhage was identif ied. We conclude that intracystic hemorrhage can occur in a simple Mullerian vaginal cyst in the absence of endometrial components.

Establishment of endometriotic models: the past and future

Endometriosis is a prevalent chronic disease that affects approximately 6%to 10%of reproductive-aged women.Although numerous researchers have endeavored to explore the etiology of endometriosis over a century,its etiology still remains an enigma.The exploration of pathophysiologic mechanism and novel therapy for endometriosis depends on ideal endometriotic models.In the previous decade,various endometriotic models have been established;therefore,we made a conclusion for available information on these models.This review summarized the common experimental models used in endometriotic studies,including their origins,characteristics,applications,and limitations.Endometriotic models played an important role in studying etiologies and novel treatments of endometriosis during the last decades.Among them,animal models and endometriotic cell lines were viewed as most common studying tools to explore the intrinsic entities of endometriosis.In addition,endometrial organoid also emerged and was regarded as an ideal studying tool for endometriosis research.Different research models collectively complement each other to advance the endometriosis research.The successful establishment of endometrial organoids means that organoids are expected to become an ideal model for studying endometriosis in the future.