title: Histologic analysis of endometriomas: what the surgeon needs to know.
abstract: OBJECTIVE
  To evaluate by thorough pathologic analysis the histologic features of the endometrioma wall excised at laparoscopy.
  
  
  METHODS
  Prospective series of consecutive patients.
  
  
  METHODS
  Tertiary care, university hospital.
  
  
  METHODS
  Fifty-nine patients with ovarian endometriomas. A total of 70 cysts were examined.
  
  
  METHODS
  Patients underwent operative laparoscopy with the stripping technique for excision of the ovarian endometrioma.
  
  
  METHODS
  A thorough histologic examination was performed on the entire cyst wall specimen.
  
  
  RESULTS
  Histologic examination confirmed the endometriotic nature of the cyst in 100% of the cases. The inner wall of the endometrioma was covered by endometriotic tissue on 60% of the surface. The mean cyst wall thickness was 1.4 mm. The mean value of maximal depth of endometriosis penetration in the endometrioma wall was 0.6 mm. In 99% of the cases the maximal penetration of the endometriotic tissue was <1.5 mm.
  
  
  CONCLUSIONS
  In the present study, we demonstrate that the endometrioma wall contains endometriotic tissue in 100% of the cases. However, the endometriotic tissue may cover the inner cyst wall for a surface that varies between 10% and 98% of the entire wall (median value 60%). This tissue may reach a depth of 2 mm, but for most of the surface it does not penetrate >1.5 mm. These histologic data may help the gynecologic laparoscopist select the surgical approach that maximally preserves healthy ovarian tissue.
authors.affiliation: Department of Obstetrics and Gynecology, University Campus Bio-Medico of Rome, Rome, Italy. l.muzii@unicampus.it <l.muzii@unicampus.it>
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.forename: Antonella
authors.initials: A
authors.lastname: Bianchi
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Emanuela
authors.initials: E
authors.lastname: Cristi
authors.forename: Milena
authors.initials: M
authors.lastname: Pernice
authors.forename: Marzio A
authors.initials: MA
authors.lastname: Zullo
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010049:Ovarian Diseases / Q000473:pathology* / Q000601:surgery*; D010053:Ovary / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures / Q000379:methods*