Dysfunctional endometres in Libreville: 20 years retrospective study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20213912Keywords:
Retrospective study, Histological study, Dysfunctional endometers, Endometrial polypsAbstract
Background: The objectives of this work were to inventory the different morphological entities, to alert the medical class to the need for multidisciplinary care; to sensitize the health authorities on this pathology having a considerable influence on the fertility of the woman and a possible evolution towards cancerous disease.
Methods: A retrospective study was carried out over 20 years from January 1983 to December 2002 at the laboratory of anatomy pathology of the faculty of health sciences in Libreville. The revealing clinical signs were the couple's bleeding and infertility. Curettage, endometrial biopsy, and subtotal or total hysterectomy were fixed with 10% buffered formalin or Bouin's fluid. After staining, histological study was carried out by the pathologist.
Results: The histological images of the endometrial polyps were the most representative (73 cases or 17.68%), followed by prolonged proliferative endometers (70 cases, or 16.95%), glandulo-cystic hyperplasia (66 cases, or 15.98%) and persistent proliferative endometers (58 cases, or 14.04%). More than half of the numbers concerned women under 35 (225/413 cases); in those over 45 years of age, the predominantly endometrial carcinoma was found. The most affected province was Woleu-Ntem (24%), followed by Haut-Ogooué (18%).
Conclusions: The different dysfunctional endometers are also described in the different regions of the continent. The management of these aims to be multidisciplinary and urgently requires a frank collaboration between clinician and morphologist, especially for country where a birth policy is clearly expressed by governing bodies.
References
Lansac J, Lecomte P, Marret H. Gynécologie pour le praticien. SIMEP. Paris. 1994;4.
Dallenbach-Hellweg G. Changes in the endometrium caused by endogenous hormonal dysfunction. Verh Dtsch Ges Pathol. 1997;81: 213-8.
Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind C. Atlas TNM : Guide illustré de la Classification TNM / pTNM des tumeurs malignes. 4th ed. Springer, editor. France: Broché; 1998.
Rodríguez-Manzaneque JC, Graubert M, Iruela-Arispe ML. Endothelial cell dysfunction following prolonged activation of progesterone receptor. Hum Reprod. 2000;15(3):39-47.
Clark TJ, Neelakantan D, Gupta JK. The management of endometrial hyperplasia: an evaluation of current practice. Eur J Obstet Gynecol Reprod Biol. 2006;125:259-64.
Sakande B, Lankoande J, Ouattara T, Ouedraogo A, Ouedraogo C, Kone B et al. Les biopsies de l endomètre au Centre Hospitalier National Yalgado Ouedraogo De Ouedraogo (Burkina-Fasso ). Principales indications et aspects histologique. Med Afr Noire. 1998;45:117-21.
Mbakop A, Kassia JM, Nkegoum B. Contribution à l’étude anatomo-clinique des hyperplasie de l endomètre. A propos de 67 cas observés à l’hôpital Central et a l’hôpital Général de Yaoundé. Le J Cameroun méd. 1996;2:20-3.
Woodruff JD, Parmley TH, Kurman RJ. Atlas of gynecologic pathology. Raven Press. 1988.
Philippe E, Charpin C. Pathologie gynécologique et obstétricale. Masson E, editor. Paris, Masson. 1992.
Nuovo MA, Nuovo GJ, McCaffrey RM, Levine RU, Barron B, Winkler B. Endometrial polyps in postmenopausal patients receiving tamoxifen. Int J Gynecol Pathol Off J Int Soc Gynecol Pathol. 1989;8:12531.
Delarue T, Baty A, Foissey A. Ménorragies, métrorragies et endomètre: à propos de 300 cas. J gynécologie Obs Biol la Reprod. 1988;17:57-64.
Jacks TH, Obed JY, Agida ET, Petrova GV. Dysmenorrhoea and menstrual abnormalities among postmenarcheal secondary school girls in Maiduguri Nigeria. Afr J Med Med Sci. 2005;34:87-9.
Kazadi Buanga J. Metrorragies endo-uterines: données etiologiques par l’histologie une série retrospective de 214 curetages. Med Afr Noire. 2001;48:30-2.
Kazadi-Buanga J, Jurado-Chacon M. Etiologic study of 275 cases of endo-uterine hemorrhage by uterine curettage. Rev Fr Gynecol Obstet. 1994;89:129-33.
Hertig AT. Tumors of the Female Sex Organs: Tumors of the Vulva, Vagina and Uterus. Supplement. Armed Forces Institute Pathol.1968;283-334.
Mandengou JR, Minko-Etoua D, Mabika B. Étude rétrospective des hyperplasies de l’ endomètre au Gabon. Université des Sciences de la Santé. 2000.
Garuti G, Cellani F, Garzia D, Colonnelli M, Luerti M. Accuracy of hysteroscopic diagnosis of endometrial hyperplasia: a retrospective study of 323 patients. J Minim Invasive Gynecol. 2005;12: 247-53.
Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004;59:368-78.
Ferenczy A, Gelfand MM, Tzipris F. The cytodynamics of endometrial hyperplasia and carcinoma. A review. Ann Pathol. 1983;3:189-201.
Vakiani M, Vavilis D, Agorastos T, Stamatopoulos P, Assimaki A, Bontis J. Histopathological findings of the endometrium in patients with dysfunctional uterine bleeding. Clin Exp Obstet Gynecol. 1996;23: 236-9.
Philippe E, Charpin C. Pathologie Gynécologique et obstétricale. Masson E, editor. Paris. 1993.
Meye JF, Mabika, Mabika B, Belembaogo E, Minko Mi Etoua DIN, Engonga Beka T et al. Les carcinomes de l endomètre au Gabon, étude de 34 cas sur 11 ans : 1988-1998. Cah santé. 2000;10:43-5.
Schnatz PF, Guile M, O’Sullivan DM, Sorosky JI. Clinical significance of atypical glandular cells on cervical cytology. Obstet Gynecol. 2006;107:701-8.
Simionescu C, Florescu M, Niculescu M, Bălă S, Manea M. Histopathologic aspects of the limited endometrial hyperplasias--a study concerning 149 cases. Rom J Morphol Embryol Rev Roum Morphol Embryol. 2005;46:51-5.
Bergeron C. Les prélèvements cytologiques et histologiques de l’endomètre pendant la ménopause: Imagerie gynécologique à la ménopause. Reprod Hum Horm. 1997;10:482-5.
De Meuron A, De Grandi P, Ruzicka J, Gloor E. Early diagnosis of premalignant and malignant lesions of the endometrium. Evaluation of a device for collecting intrauterine samples (the Inocurette) compared with exploratory curettage. J Gynecol Obstet Biol Reprod (Paris). 1986;15:1035-42.
Agostini A, Schaeffer V, Cravello L, Bretelle F, Roger V, Blanc B. Place de l’hystéroscopie dans le diagnostic et la prise en charge des hyperplasies atypiques de l’endomètre. Gynécologie Obs Fertil. 2003;31:355-8.
Chamlian DL, Taylor HB. Endometrial hyperplasia in young women. Obstet Gynecol. 1970;36: 659-66.
Tabata T, Yamawaki T, Yabana T, Ida M, Nishimura K, Nose Y. Natural history of endometrial hyperplasia. Study of 77 patients. Arch Gynecol Obstet. 2001;265:85-8.
Greenwood SM, Wright DJ. Evaluation of the office endometrial biopsy in the detection of endometrial carcinoma and atypical hyperplasia. Cancer. 1979;43:1474-8.
Hendrickson MR, Kempson RL. Surgical pathology of the uterine corpus. Major Probl Pathol. 1979;12:1-580.
De Brux J. Histopathologie gynécologique. Masson, Editeurs. 1971.