"Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer."

Pietro G Signorile; Feliciano Baldi; Rossana Bussani; Mariarosaria D'Armiento; Maria De Falco; Alfonso Baldi

doi:10.1186/1756-9966-28-49

Endometriosis · Pathophysiology

"Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer."

Signorile PG, Baldi F, Bussani R, D'Armiento M, De Falco M, Baldi A

Journal of Experimental & Clinical Cancer Research, 28(1), 2009

DOI 10.1186/1756-9966-28-49 PMID 19358700 PMC PMC2671494

Read our synopsis

RRM Academy Synopsis

Endometrial-like tissue found outside the uterus in 4 of 36 fetuses

Four of 36 female fetuses had endometrial-like tissue outside the uterus, a 2009 autopsy study found. Researchers stained the pelvic organs for two markers. The authors say this supports the müllerianosis theory of endometriosis.

Key Findings

The study collected 36 human female fetuses at autopsy, none with visible alteration of the pelvic organs.
Four fetuses (11% of cases) carried organoid structures outside the uterine cavity that resembled primitive endometrium.
The structures expressed both CA125 and the estrogen receptor.
Locations were the recto-vaginal septum, the area near the Douglas pouch, tissue behind the uterus, the muscle layer of the rectum, and the uterine wall.
The authors compare the 11% with endometriosis prevalence in the general female population, given as 6–10%.

Interpretation

This is a small autopsy series. The pelvic organs were examined under the microscope after autopsy. The authors interpret the structures as differentiated endometrial tissue misplaced before birth. The study examined fetuses only, so the link to later endometriosis is the authors' hypothesis. The authors write that 36 fetuses are too few for definitive conclusions and that other causes cannot be completely ruled out.

RRM Context

Restorative reproductive medicine looks for where a disease starts. The authors cite evidence that seems to contradict retrograde menstruation as the explanation. 90% of women have retrograde flow, yet less than 15% get endometriosis. The authors conclude that complete surgery can be considered curative.

Our editorial summary of this paper, not the article's abstract.

Abstract not indexed.

Topics

Related research

Pathophysiology · Origin Theories

Pathogenesis and pathophysiology of endometriosis

Burney RO et al., 2012 Fertility and Sterility Free full text on PubMed Central

Pathophysiology · Origin Theories

Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation

Sampson JA, 1927 Am J Pathol

Pathophysiology · Origin Theories

Endometriosis

Giudice LC et al., 2004 Lancet

Endometriosis is an oestrogen-dependent disorder that can result in substantial morbidity, including pelvic pain, multiple operations, and infertility. New findings on the genetics, the possible roles of the environment and the immune system, and intrinsic abnormalities in the endometrium of affected women and secreted products of endometriotic lesions have given insight into the pathogenesis of this disorder and serve as the background for new treatments for disease-associated pain and infertility. Affected women are at higher risk than the general female population of developing ovarian cancer, and they also may be at increased risk of breast and other cancers as well as autoimmune and atopic disorders. Clinicians should assess and follow up affected women for these and other associated disorders. There will probably be a new repertoire of approaches for treatment and perhaps cure of this enigmatic disorder in the near future.

Pathophysiology · Origin Theories

Stem cell and endometriosis: new knowledge may be producing novel therapies

Yang J et al., 2014 International journal of clinical and experimental medicine Free full text on PubMed Central

The human endometrium is a dynamic tissue, which undergoes cycles of growth and regression with each menstrual cycle. Adult progenitor stem cells are likely responsible for this remarkable regenerative capacity; these same progenitor stem cells may also have an enhanced capacity to generate endometriosis if shed in a retrograde fashion. The progenitor stem cells reside in the uterus, and, however, may also travel from other tissues such as bone marrow to repopulate the progenitor population. Mesenchymal stem cells are also involved in the pathogenesis of endometriosis and may be the principle source of endometriosis outside of the peritoneal cavity when they differentiate into endometriosis in ectopic locations. The present short review mainly summarizes the latest observations contributing to the current knowledge regarding the presence and the potential contribution of stem cells in the etiology of endometriosis. All these data can have clinical implications and provide a basis for new potential therapeutic applications.

Endometriosis › Pathophysiology › Origin Theories · General Gynecology › Gynecologic Oncology › Endometrial Cancer

Rossana Bussani, Maria De Falco, Alfonso Baldi, Feliciano Baldi, Mariarosaria D'Armiento, Pietro G Signorile

R Bussani, M Falco, A Baldi, F Baldi, M D'Armiento, P Signorile

PMID 19358700 19358700 DOI 10.1186/1756-9966-28-49 10.1186/1756-9966-28-49 Signorile et al. 2009, Signorile 2009

Cite this article

Signorile, P. G., Baldi, F., Bussani, R., D'Armiento, M., De Falco, M., & Baldi, A. (2009). "Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer.". Journal of Experimental & Clinical Cancer Research, 28(1). https://doi.org/10.1186/1756-9966-28-49