To the best of our knowledge, this observation is the first direct evidence in human female foetuses of the presence of ectopic endometrium outside the uterine cavity. Our data sustain the müllerianosis hypothesis of an embryological origin for endometriosis, suggesting alterations in the fine tuning of female genital structures organogenesis, possibly caused by environmental toxicants. Interestingly, the percentage of foetuses analyzed AZD1208 molecular weight in our study, that displayed the presence of ectopic endometrium is very similar to the prevalence of women suffering

for this disease in the general population [1–3]. This further suggests a strict link between embryological abnormalities and onset of the disease, even if the number of foetuses analyzed is too small in order to reach definitive

conclusions. Further studies are urgently required in order to better define the molecular mechanisms underlying this phenomenon. In particular, www.selleckchem.com/products/gdc-0068.html ad hoc in vitro and in vivo models should be set up to analyze the effects on cell homeostasis and on the morphogenesis of the female genital system of different endocrine disruptors. Considering that, based on epidemiological studies, women with endometriosis have an increased risk of different types of malignancies, especially ovarian cancer and non-Hodgkin’s lymphoma [1], the implications of these findings could be very important

also in the oncology field. Conclusion The clinical and therapeutic implications of this observation are straightforward. Endometriosis could not be regarded as a recurrent disease, therefore surgery, if complete can be considered curative and it would be not justified post-operative hormonal treatments. Nevertheless, it must be underlined the fact that other pathogenetic mechanisms for the genesis of endometriosis can not be completely ruled out by these observation, even if, to date, there are no direct evidence of their validity. Acknowledgements This work was supported by a grant from “”Fondazione Italiana Endometriosi”". References 1. Baldi A, Campioni M, Signorile PG: Endometriosis: Phosphoglycerate kinase pathogenesis, diagnosis, therapy and association with cancer. Oncol Reports 2008, 19: 843–846. 2. Giudice LC, Kao LC: Endometriosis. The Lancet 2004, 364: 1789–1799.CrossRef 3. Houston DE: Evidence for the risk of pelvic endometriosis by age, race, and socioeconomic status. Epidemiol Rev 1984, 6: 167–191.PubMed 4. Koninckx PR, Martin D: Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol 1994, 6: 231–234.PubMed 5. Signorile PG, Campioni M, Vincenzi B, D’Avino A, Baldi A: Rectovaginal septum endometriosis: an immunohistochemical analysis of 62 cases. In Vivo 2009, in press. 6. Nap AW, Groothuis PG, Demir AY, Evers JL, Dunselman GA: Pathogenesis of endometriosis.