Histopathological patterns and topographic distribution of endometriosis: A 10-year retrospective study at a South African tertiary institution

Florence L. Masha, Nosipho Maria Thobakgale, Thobakgale NM, Moshawa Calvin Khaba
In: Journal of the Colleges of Medicine of South Africa · 2026 · vol. 4(1) · doi:10.4102/jcmsa.v4i1.421 · W7222758699
Observational OA: diamond CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by qwen3.7-flash, 2026-10-21 ⓘ

This retrospective study analyzed 156 histopathologically confirmed endometriosis cases in South Africa, revealing ovarian predominance, specific histological patterns, and age-related cervical involvement to address limited regional epidemiological data.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-10-21 · read from full text ⓘ

This retrospective study analyzed archival pathology data from a South African tertiary institution to determine the histopathological patterns and anatomical distribution of endometriosis over a ten-year period. Among 93,804 female specimens, 156 cases were confirmed, with the ovary being the most frequently affected site and the majority of lesions displaying all three classic histological features. The research noted that cervical endometriosis was associated with older age, although this finding was based on a small number of cases, and identified synchronous involvement in a minority of patients. This paper is centrally about endometriosis, specifically focusing on its histopathological characteristics and topographic distribution within a previously underrepresented geographic region.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Background: Endometriosis affects approximately 190 million women globally; however, despite this, epidemiological data on endometriosis from Africa remain scarce. Understanding regional disease patterns, histopathological characteristics, and anatomical distribution is essential for improving diagnostic accuracy and clinical management. Methods: A retrospective cross-sectional study was conducted using archival data from the Department of Anatomical Pathology at the Dr George Mukhari Academic Laboratory, Ga-Rankuwa, South Africa, from 01 January 2012 to 31 December 2021. Histopathologically confirmed cases of endometriosis were identified using SNOMED codes. Demographic and clinical data were analysed using Stata 14, with Chi-square and Fisher’s exact tests to assess associations (p < 0.05). Results: Of 93 804 female specimens examined, 156 cases of endometriosis were confirmed (histopathological diagnostic frequency = 0.166%). The mean age at diagnosis was 36.97 years. The most common histopathological pattern (60.3%) demonstrated all three classic features. The ovary was the most frequently affected site (36.5%). Synchronous involvement at multiple sites occurred in 9.6% of cases, predominantly affecting the adnexa. Endometriotic cysts were identified in 28.8% of patients. Cervical endometriosis was associated with older age (≥ 50 years), although based on a small number of cases (p = 0.008). Associated lesions were identified in 24.4% of the cases. Conclusion: These findings contribute to the limited epidemiological data on endometriosis in Africa and emphasise the need for heightened clinical awareness, particularly for extrauterine manifestations that may present diagnostic challenges. Contribution: This study contributes to the limited South African data by providing detailed insights into the histopathological diagnostic frequency, anatomical distribution and histopathological patterns, enhancing understanding of disease patterns.
Full text 3,159 characters · extracted from oa-html · 5 sections · click to expand

Abstract

Background: Endometriosis affects approximately 190 million women globally; however, despite this, epidemiological data on endometriosis from Africa remain scarce. Understanding regional disease patterns, histopathological characteristics, and anatomical distribution is essential for improving diagnostic accuracy and clinical management.

Methods

A retrospective cross-sectional study was conducted using archival data from the Department of Anatomical Pathology at the Dr George Mukhari Academic Laboratory, Ga-Rankuwa, South Africa, from 01 January 2012 to 31 December 2021. Histopathologically confirmed cases of endometriosis were identified using SNOMED codes. Demographic and clinical data were analysed using Stata 14, with Chi-square and Fisher’s exact tests to assess associations (p < 0.05).

Results

Of 93 804 female specimens examined, 156 cases of endometriosis were confirmed (histopathological diagnostic frequency = 0.166%). The mean age at diagnosis was 36.97 years. The most common histopathological pattern (60.3%) demonstrated all three classic features. The ovary was the most frequently affected site (36.5%). Synchronous involvement at multiple sites occurred in 9.6% of cases, predominantly affecting the adnexa. Endometriotic cysts were identified in 28.8% of patients. Cervical endometriosis was associated with older age (≥ 50 years), although based on a small number of cases (p = 0.008). Associated lesions were identified in 24.4% of the cases.

Conclusion

These findings contribute to the limited epidemiological data on endometriosis in Africa and emphasise the need for heightened clinical awareness, particularly for extrauterine manifestations that may present diagnostic challenges. Contribution: This study contributes to the limited South African data by providing detailed insights into the histopathological diagnostic frequency, anatomical distribution and histopathological patterns, enhancing understanding of disease patterns.

Keywords

Sustainable Development Goal Metrics Total abstract views: 70Total article views: 62

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-html ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (20)

Source provenance

openalex
last seen: 2026-10-23T06:00:16.390838+00:00
License: CC0 · commercial use OK