Bowel Endometriosis Seen As Potentially Serious Condition

Disease shares some characteristics of malignancy, including lymph-node involvement

FRIDAY, Sept. 22 (HealthDay News) -- Bowel endometriosis should no longer be considered a clinically benign disease because it can affect substantial areas of the bowel wall and involve the lymph nodes, according to a study in the September issue of Fertility and Sterility.

Mauricio S. Abrao, M.D., of Sao Paulo Medical School in Sao Paulo, Brazil, and colleagues assessed 35 cases of bowel endometriosis and conducted a histologic analysis of tissue samples removed at laparoscopic rectosigmoidectomy.

The researchers' analysis showed lymph nodes in the pericolic adipose tissue of 19 cases (54 percent), including five cases in which endometriosis affected the lymph nodes. They also found that the lymph nodes of all patients were affected when the thickness of the endometriotic lesion reached 1.75 cm, and in more than 80 percent of patients when the circumference of the intestinal loop was affected by endometriosis.

"Endometriosis is considered a benign disorder; however, it shares some of the characteristics of malignancy, such as abnormal morphology, deregulated cell growth, cellular invasion, and neoangiogenesis," the authors write. "Bowel endometriosis is one of the greatest concerns of specialists treating infiltrative endometriosis because of the severity of its symptoms, concomitant infiltration of pelvic organs, the possibility of bowel obstruction resulting from the progression of the disease, and the technical difficulties of its surgical removal."

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