Endometriosis in para-aortic lymph nodes during pregnancy

Case report and review of literature

Anna L. Beavis, Koji Matsuo, Brendan H. Grubbs, Sucheta A. Srivastava, Christina M. Truong, Melissa Moffitt, Ana M. Maliglig, Yvonne G. Lin

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To report a case of endometriosis in para-aortic lymph nodes during pregnancy. Design: Case report. Setting: Tertiary care center. Patient(s): A 25-year-old multipara pregnant woman with a history of chronic pelvic pain and ovarian cystectomies for bilateral endometriomas. Intervention(s): The patient was admitted with a placenta previa and a subchorionic hemorrhage at 24 weeks 5 days' gestation, and subsequently developed uterine contractions. Magnetic resonance imaging revealed a large complex adnexal mass adherent to the uterus and pelvic and para-aortic lymphadenopathy. Tocolysis could not be achieved and the patient underwent cesarean delivery at 26 weeks 3 days. An implant on the uterus and an enlarged para-aortic lymph node were removed surgically at that time. Main Outcome Measure(s): Involvement of lymph node by endometriosis and presence of a recurrent endometrioma. Result(s): Endometriosis was confirmed pathologically in para-aortic lymph nodes. Uterine serosal biopsy demonstrated endometriosis, and the large adnexal cyst was grossly consistent with endometrioma. The patient delivered a viable male infant at 26 weeks 3 days. Conclusion(s): To our knowledge, this is the first reported case of endometriosis in para-aortic lymph nodes. Its presence supports the hypothesis that endometriosis travels lymphatically, and not simply via locoregional spread. Lymphatic spread also further supports the theory that endometriosis is an aggressive chronic systemic disease.

Original languageEnglish (US)
JournalFertility and Sterility
Volume95
Issue number7
DOIs
StatePublished - Jun 2011
Externally publishedYes

Fingerprint

Endometriosis
Lymph Nodes
Pregnancy
Uterus
Tocolysis
Placenta Previa
Uterine Contraction
Pelvic Pain
Cystectomy
Tertiary Care Centers
Chronic Pain
Cysts
Pregnant Women
Chronic Disease
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Hemorrhage
Biopsy

Keywords

  • Endometriosis
  • lymph node
  • metastasis
  • pregnancy
  • review

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Endometriosis in para-aortic lymph nodes during pregnancy : Case report and review of literature. / Beavis, Anna L.; Matsuo, Koji; Grubbs, Brendan H.; Srivastava, Sucheta A.; Truong, Christina M.; Moffitt, Melissa; Maliglig, Ana M.; Lin, Yvonne G.

In: Fertility and Sterility, Vol. 95, No. 7, 06.2011.

Research output: Contribution to journalArticle

Beavis, Anna L. ; Matsuo, Koji ; Grubbs, Brendan H. ; Srivastava, Sucheta A. ; Truong, Christina M. ; Moffitt, Melissa ; Maliglig, Ana M. ; Lin, Yvonne G. / Endometriosis in para-aortic lymph nodes during pregnancy : Case report and review of literature. In: Fertility and Sterility. 2011 ; Vol. 95, No. 7.
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