Endometriosis is an inflammatory gynecological disorder among reproductive-aged women caused by the engraftment and proliferation of endometrial cells outside the uterus, most commonly in the pelvis. It is thought that the disease arises primarily from
retrograde menstruation where cells from the endometrium travel through the fallopian tubes to the peritoneal cavity. However, migration of
endometriosis-derived cells to distant organs outside of the peritoneal cavity have not been explored. In the present study, we developed and validated a mouse model of disseminated
endometriosis using syngeneic
DsRed endometrial tissue introduced into the peritoneum of immunocompetent mice. Flow cytometry and immunofluorescence analysis, demonstrated the presence of
endometriosis-derived cells in multiple organs (including lung, spleen, liver and brain) in the murine
endometriosis model. Immunostaining revealed the presence of
DsRed+/CD45- cells in brain, liver and lung. Engraftment occurred in all experimental animals examined. Cells from endometriotic lesions are capable of migration to and engraftment of multiple organs outside of the peritoneal cavity.
Micrometastasis of
endometriosis is a novel and frequent phenomenon. These data suggest that widespread dissemination of
endometriosis may be common, clinically unrecognized and contribute to the diffuse clinical manifestations of this disease.