Expression of estrogen and progesterone receptors in subcutaneous endometriosis

Abstract

Endometriosis is a clinical disorder defined by the presence of functional endometrial tissue outside the uterine cavity. Depending on the localization of the endometrial tissue related to the pelvis, the endometriosis can be classified either as intrinsic or extrinsic. The prevalence of endometriosis is difficult to determine. Statistical data show that endometriosis could be associated both with female infertility (20%) and pelvic pains (24%), while in 4.1% of affected women, endometriosis has asymptomatic forms. The total prevalence of endometriosis is estimated to be between 5-10%. A 35-year-old woman from Knic, Serbia, was admitted to the Obstetrics and Gynecology Clinic of the Clinical Center in Kragujevac for surgical treatment of a suspicious swelling in the pubic region. Following surgical intervention, a nut-sized tumor was removed and sent for both pathohistological and immunohistochemical analysis. The results confirmed the presence of subcutaneous endometriosis positive for both estrogen and progesterone receptors. Endometriosis is usually described as a steroid hormone-dependent change that resembles the eutopic endometrial tissue characteristic for the presence of both glandular and stromal tissues. Given the fact that endometrial lesions are estrogen-dependent tumors, a crucial factor in the development of endometriosis is a late exposure to the hormone, mostly estrogen. Spontaneous subcutaneous endometriosis is rarely observed, but it could be assumed if there is recurrent pelvic pain which intensifies during menstruation. Given the fact that endometriosis coexists with different autoimmune diseases, multidisciplinary approaches are required for its proper diagnosis.