Age‐dependent phenotypes of ovarian endometriomas. (21st January 2022)

• Record Type: Journal Article
• Authors: Benagiano, Giuseppe; Guo, Sun‐Wei
• Is Part Of: Reproductive medicine and biology. Volume 21:Number 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-01-21
• Subjects: adolescence -- adulthood -- neonatal uterine bleeding -- ovarian endometrioma -- postmenopause -- premenarche; Reproduction -- Periodicals; Reproductive health -- Periodicals; 612.6
• DOI: 10.1002/rmb2.12438
• Languages: English
• ISSNs: 1445-5781

Abstract

Abstract: Purpose: To analyze the characteristics of the ovarian endometrioma (OE) across the life span of a woman. In the past, the OE has traditionally been viewed as a single, monolithic disease. Today, there are emerging data indicating that OE phenotypes differ according to the age of the woman. Method: A narrative review of original articles on OE indexed by PubMed. Results: When appearing in infancy and early adolescence, OE may be the consequence of endometrial cells retrogradely shed with neonatal uterine bleeding. The post ‐ menarcheal variant, manifesting itself during full adolescence, is singularly frequent in the presence of vaginal or uterine outflow obstructive anomalies. The typical and most frequent adult phenotype is characterized by increasing fibrosis and a tendency to progress; its mere presence exerts a detrimental effect on the surrounding healthy ovarian tissue. In postmenopause, an old lesion may be reactivated in the presence of exogenous or endogenous estrogens, or even be produced ex novo ; rarely, it can spread to a variety of organs and structures and even degenerate causing malignancies. Conclusions: Given the existence of these variants, it is important to agree on management guidelines that take into consideration these different phenotypes. Abstract : Traditionally, ovarian endometriomas are considered rightfully as one subtype of endometriosis that is different from other subtypes. Beyond that, it is considered as a monolithic disease entity. In this review, we synthesized published data and argue that this subtype actually has age‐dependent phenotypes, and as such, management should be ideally tailored to achieve the best results.