Abdominal Wall Endometriosis: Myofibroblasts as a Possible Evidence of Metaplasia: A Case Report.
In this study, we report about a patient with extra-uterine endometriosis (EM) in the abdominal wall muscle with evident metaplasia based on the abundant alpha smooth muscle actin (ASMA)-expressing myofibroblasts. Laparotomy excision of the abdominal wall EM was done following ultrasonographic evidence of a hypodense swelling in the right rectus abdominis, which was confirmed by MRI. Immunohistochemistry staining for ASMA and collagen I was done, with the results confirming that endometriotic stromal cells expressed both. Anterior abdominal wall endometriosis was suspected because of the patient's history of recurrent EM combined with the cyclic nature of symptoms. MRI is useful in determining the extent of the disease. In case of persisting symptoms even under hormonal treatment, surgical excision is mandatory. The expression of both ASMA and collagen I in and around EM lesions supports the notion of the metaplastic process in the course of disease development.
Endometriosezentrum Charité, Gynecology Clinic, Charité Universitätsmedizin - Campus Benjamin Franklin, Berlin, Germany.
Mohamed Gamal
MG
Ibrahim
Eleonore
E
Delarue
Elene
E
Abesadze
Matthias
M
Haas
Jalid
J
Sehouli
Vito
V
Chiantera
Sylvia
S
Mechsner
D034861:Abdominal Wall / Q000000981:diagnostic imaging / Q000473:pathology* / Q000502:physiology; D000199:Actins / Q000096:biosynthesis; D000328:Adult; D024042:Collagen Type I / Q000096:biosynthesis; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008679:Metaplasia; D058628:Myofibroblasts / Q000378:metabolism / Q000473:pathology*; D017568:Rectus Abdominis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*
D000199:Actins; D024042:Collagen Type I