Deep Infiltrating Endometriosis in Dizygotic Twins: A Case Report and a Review of Literature

This paper reports a case of dizygotic twins (women in their mid-20s) with very similar severe posterior-compartment deep infiltrating endometriosis (rectovaginal DIE) and compares their high-level diagnostic workup (transvaginal ultrasound and pelvic MRI) and surgical management via fertility-sparing laparoscopic excision. Both twins had comparable symptom patterns, nearly identical intraoperative findings, and significant postoperative pain improvement; pathology in each case supported endometriosis involvement at the rectovaginal septum/adjacent structures, though specific associated findings differed (e.g., endometrioma and ureteral involvement). The authors explicitly acknowledge that evidence for heritability specifically in DIE is limited, making this report primarily descriptive and not a controlled test of inheritance. This paper is centrally about endometriosis — it provides a rare dizygotic-twin case report aimed at demonstrating shared heritable risk for rectovaginal deep infiltrating endometriosis.

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