Korean J Obstet Gynecol.  1999 May;42(5):1043-1047.

The Difference between Clinical Diagnosis and Histologic Diagnosis of Endometrioma

• Oh ST
• Lee GM
• Kim BR

Abstract

OBJECTIVE
The purpose of this study is to find the proper clinical diagnostic criteria of clinical diagnosis for endometrioma by comparing to histologic diagnosis.
METHODS
Our study was performed in 140 patients, who were diagnosed hemorrhagic ovarian cyst by diagnostic laparoscopy or MRI and received the laparoscopic cyst wall stripping. The our clinical diagnostic criteria for endometrioma are as follows: 1] endometrioma is diagnosed if endometrial epithelium, gland or stroma is histologically proven. 2] it is not diagnosed to endometrioma if cystic content is not thick but watery. 3] if more than two findings are present among hemosiderin-laden macrophages, moderate to severe adhesion, endometrial spot in peritoneal cavity, we diagnosed as endometrioma.
RESULTS
If histologically proven endometrial epithelium, gland or stroma was only included in diagnostic criteria, 63/140[45%] patients were diagnosed as endometrimas. If hemosiderin-laden macrophage findings with severe adhesion and presence of surface endometriotic spots were included in diagnostic criteria although histologically not proven endometrial tissue, 86/140 [61.4%] patients were diagnosed. If they are diagnosed by our criteria, 124/140[87.9%] patients were diagnosed. The endometrial tissue was not found in 77/140 patients, and 70/77 patients had preoperative dysmenorrhea, dyspareunia or chronic pelvic pain. The 69/70 patients were diagnosed as endometriomas by our criteria, and the pains were markedly subside in 60/69 patients postoperatively and moderately subside in 9/69 patients. The hemorrhagic cysts were recurred in 5/77 patients, and endometrial tissues were proved in 3/5 patients on second operation.
CONCLUSION
The clinical diagnostic criteria is needed on histologic diagnosis for more perfect postoperative management of endometrioma patients, and the establishment of this criteria for clinical diagnosis is necessary by future many investigations.

Keyword

Endometrioma; histologic diagnosis

MeSH Terms

Diagnosis*
Dysmenorrhea
Dyspareunia
Endometriosis*
Epithelium
Female
Humans
Laparoscopy
Macrophages
Magnetic Resonance Imaging
Ovarian Cysts
Pelvic Pain
Peritoneal Cavity