Endometriosis and ovarian cancer

Introduction Endometriosis has been traditionally defined as the presence of endometrial glands and stroma in ectopic locations. This disease affects approximately 6 to 10% of reproductive-aged women, resulting in dysmenorrhea, dyspareunia, chronic pelvic pain, and/or infertility [1]. Endometriosis is a debilitating condition, posing quality-of-life issues for the individual patient. The prevalence of endometriosis in women experiencing pain, infertility, or both can be as high as 50%. The disorder represents a major cause of gynecologic hospitalization in the United States resulting in over $3 billion in inpatient health care costs in 2004 alone [2,3]. The significant individual and public health concerns associated with endometriosis are paramount to understanding its pathogenesis. The first recorded description of pathology consistent with endometriosis was provided by Shroen in 1690 [4,5]. Despite decades of extensive clinical and scientific investigation, the exact pathogenesis of this enigmatic disorder still remains largely unknown. Theories regarding pathogenesis of endometriosis Numerous theories detailing the development of endometriosis have been described. These theories can generally be classified into two groups: (1) Nonendometrial, those that propose that implants arise from tissues other than the endometrium, and (2) Endometrial, those that propose that implants arise from uterine endometrium (Table 14.1).