Research

Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer

Pietro G Signorile¹ , Feliciano Baldi² , Rossana Bussani³ , Mariarosaria D'Armiento⁴ , Maria De Falco⁵ and Alfonso Baldi^1,2

¹  Fondazione Italiana Endometriosi, Rome, Italy

²  Dept Biochemistry, Sect Pathology, Second University of Naples, Naples, Italy

³  Dept. of Pathology, University of Trieste, Trieste, Italy

⁴  Dept. Scienze Biomorfologiche, University of Naples "Federico II", Naples, Italy

⁵  Dept Evolutive and Comparative Biology, University of Naples "Federico II", Naples, Italy

author email corresponding author email

Journal of Experimental & Clinical Cancer Research 2009, 28:49doi:10.1186/1756-9966-28-49

Published:	9 April 2009

Abstract

Background

Endometriosis is a gynecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity. Women with endometriosis have an increased risk of different types of malignancies, especially ovarian cancer and non-Hodgkin's lymphoma. Though there are several theories, researchers remain unsure as to the definitive cause of endometriosis. Our objective was to test the validity of the theory of müllerianosis for endometriosis, that is the misplacing of primitive endometrial tissue along the migratory pathway of foetal organogenesis

Methods

We have collected at autopsy 36 human female foetuses at different gestational age. We have performed a morphological and immunohistochemical study (expression of oestrogen receptor and CA125) on the pelvic organs of the 36 foetuses included en-block and totally analyzed.

Results

In 4 out of 36 foetuses we found presence of misplaced endometrium in five different ectopic sites: in the recto-vaginal septum, in the proximity of the Douglas pouch, in the mesenchimal tissue close to the posterior wall of the uterus, in the rectal tube at the level of muscularis propria, and in the wall of the uterus. All these sites are common location of endometriosis in women.

Conclusion

We propose that a cause of endometriosis is the dislocation of primitive endometrial tissue outside the uterine cavity during organogenesis.