Update March 20, 2019

Endometriosis is defined as endometrial glands and stroma that occur outside the uterine cavity.

The lesions are typically located in the pelvis but can occur at multiple sites including the bowel, diaphragm, and pleural cavity.

While endometriosis is a common and nonmalignant process, ectopic endometrial tissue and resultant inflammation can cause dysmenorrhea, dyspareunia, chronic pain, and infertility. Symptoms can range from minimal to severely debilitating.

Endometriosis is an estrogen-dependent, benign, inflammatory disease that affects women during their premenarcheal, reproductive, and postmenopausal hormonal stages.

Neurofibromatosis is a genetic disorder that causes tumors to form on nerve tissue. These tumors can develop anywhere in your nervous system, including your brain, spinal cord and nerves. Neurofibromatosis is usually diagnosed in childhood or early adulthood.

The tumors are usually noncancerous (benign), but sometimes can become cancerous (malignant).

Complications of neurofibromatosis can include hearing loss, learning impairment, heart and blood vessel (cardiovascular) problems, loss of vision, and severe pain.

Neurofibromatosis treatment aims to maximize healthy growth and development and to manage complications as soon as they arise. When neurofibromatosis causes large tumors or tumors that press on a nerve, surgery can help ease symptoms. Some people may benefit from other therapies, such as stereotactic radiosurgery or medications to control pain.

Gross and microscopic pathology

Endometriosis lesions in the pelvis can be categorized as superficial peritoneal, ovarian, and deeply infiltrating [1]. Similar to eutopic endometrial tissue, endometriosis lesions contain endometrial glands and stroma (picture 1).


Peritoneal endometriosis
Image
Light micrograph of peritoneal endometriotic implant shows endometrial glandular epithelium (arrow) and surrounding stroma.

Unlike eutopic endometrium, however, endometriosis implants often contain fibrous tissue, blood, and cysts. Breakdown of red blood cells by inflammatory cells results in formation of pigmented histiocytes and hemosiderin-laden macrophages; the older the lesion, the more likely it is to be pigmented [2]. The gross appearance and size of the implants are quite variable at the time of surgery [3]. (See 'Surgical exploration' below.)

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When neurofibromatosis causes large tumors or tumors that press on a nerve, surgery can help ease symptoms. Some people may benefit from other therapies, such as stereotactic radiosurgery or medications to control pain.

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