Clinicopathologic investigation of ovarian endometriosis: a comparative study of cystic and non-cystic types.

This clinicopathologic study involved 129 patients with ovarian endometriosis. All the lesions from the patients were classified macroscopically into two types being either cystic or non-cystic. The results are as follows. Endometriotic lesions were bilateral in 58 cases and unilateral in 71 cases. The average age of the patients was 38.8 and gravidity 1.8, with 43.1% of them being infertilite. In 12.2, 45.4 and 84.6% of them, irregular menstruation, hypermenorrhea, and dysmenorrhea were recorded, respectively. Regarding complicated lesions, 49 patients had fibroid, 33 uterine adenomyosis, and 13 rectocervical endometriosis. Of the 129 cases, 61.3% were regarded as of the cystic type, 30.2% as of the non-cystic type, and 8.5% as of the cystic/non-cystic type. The average ages were 35.5 and 41.6 years for cystic and non-cystic types, respectively. The incidence of each type of complicated lesion mentioned above was greater in the non-cystic type than that in the cystic type. The pathogenetic investigation suggested that cystic endometriosis in the ovary might mainly be ascribed to the endometrioid metaplasia of the celomic epithelium and that non-cystic endometriosis might occasionally originate from metastasis or implantation of endometrial tissues. In addition to this, the lesions which were histologically diagnosed as endometriosis might sometimes include obsolete follicle cysts undergoing luteinization.