Objectives: Angiogenesis is engaged in endometriosis. It is regulated by regulatory factors and cytokines, transported in microvesicles. The purpose was to investigate the presence of MVs with vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP-9) in peripheral blood and peritoneal fluid of women operated on for endometrioma or teratoma Material and methods: Microvesicles (MVs) were determined in blood samples and peritoneal fluid samples collected from women aged 20–60 years operated on for endometriosis (test group) and teratoma (control group). The final investigations were performed on 47 patients, who qualified for the study based on the meticulous inclusion criteria. MVs were analyzed by flow cytometry (FACS) using annexin V, antibodies for molecules characteristic of cells from endometriosis foci (keratin 18 (K18), CD105, CD146), and antibodies for intraepithelial vascular growth factor VEGF and metalloproteinase-9 (MMP-9). The sample was double “reading” using flow cytometry (FACSCantoII). Results: Cytometry analysis confirmed MVs’ presence in plasma and peritoneal fluid collected from patients with both endometriosis and teratomas. A statistically significant higher level of AnnexinV (+) MVs were observed in plasma samples of endometriosis patients. In the control group, there was a higher percentage of double-positive VEGF (+)/MMP-9 (+) and single MMP-9 (+) positive MVs in the serum. In the peritoneal fluid higher frequency of double-positive VEGF (+)/MMP-9 (+) MVs were found in the control group. However, the amount of VEGF (+) / MMP-9 (+) MVs object did not enable to differentiate between the test and control groups. The study was the first, in which MVs were confirmed in plasma and peritoneal fluid in benign adnexa tumors. Conclusions: Microvesicles are present in peripheral blood and peritoneal fluid samples collected from patients with endometriosis and teratomas. Microvesicles with proangiogenic factors (VEGF and MMP-9) are more abundant in blood and peritoneal fluid samples from patients with teratomas. Objectives: Angiogenesis is engaged in endometriosis. It is regulated by regulatory factors and cytokines, transported in microvesicles. The purpose was to investigate the presence of MVs with vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP-9) in peripheral blood and peritoneal fluid of women operated on for endometrioma or teratoma Material and methods: Microvesicles (MVs) were determined in blood samples and peritoneal fluid samples collected from women aged 20–60 years operated on for endometriosis (test group) and teratoma (control group). The final investigations were performed on 47 patients, who qualified for the study based on the meticulous inclusion criteria. MVs were analyzed by flow cytometry (FACS) using annexin V, antibodies for molecules characteristic of cells from endometriosis foci (keratin 18 (K18), CD105, CD146), and antibodies for intraepithelial vascular growth factor VEGF and metalloproteinase-9 (MMP-9). The sample was double “reading” using flow cytometry (FACSCantoII). Results: Cytometry analysis confirmed MVs’ presence in plasma and peritoneal fluid collected from patients with both endometriosis and teratomas. A statistically significant higher level of AnnexinV (+) MVs were observed in plasma samples of endometriosis patients. In the control group, there was a higher percentage of double-positive VEGF (+)/MMP-9 (+) and single MMP-9 (+) positive MVs in the serum. In the peritoneal fluid higher frequency of double-positive VEGF (+)/MMP-9 (+) MVs were found in the control group. However, the amount of VEGF (+) / MMP-9 (+) MVs object did not enable to differentiate between the test and control groups. The study was the first, in which MVs were confirmed in plasma and peritoneal fluid in benign adnexa tumors. Conclusions: Microvesicles are present in peripheral blood and peritoneal fluid samples collected from patients with endometriosis and teratomas. Microvesicles with proangiogenic factors (VEGF and MMP-9) are more abundant in blood and peritoneal fluid samples from patients with teratomas.

Uterine leiomyosarcoma (uLMS) is a rare, heterogeneous, and aggressive tumour, representing only 2–5% of all uterine neoplasms. It poses a significant diagnostic and therapeutic challenge due to symptom overlap with benign uterine conditions such as uterine fibroids. Risk factors of uLMS include advanced age, larger tumour size, submucosal localisation, prior malignancies, tamoxifen use, pelvic radiation, and higher body mass index. This review analyses 13 studies to better identify preoperative indicators of leiomyosarcoma and highlights the challenges in differentiating malignant tumours from benign fibroids. Early detection remains difficult because the clinical presentation often mimics more common benign conditions, leading to delays in diagnosis and treatment. Current diagnostic methods: clinical examination, ultrasound, magnetic resonance imaging (MRI), and histopathology, offer important clues such as tumour size, irregular margins, necrosis, and vascular patterns, but none offers definitive preoperative diagnosis. While advanced imaging techniques like dynamic MRI show promise in distinguishing uLMS from leiomyomas, these methods are not yet practical for routine use. Blood markers lack diagnostic reliability. Minimally invasive surgical procedures, such as laparoscopic power morcellation, carry risks of spreading occult malignancies and should only be performed in carefully selected patients. Therefore, comprehensive preoperative evaluations and improved diagnostic tools are critical to facilitate earlier detection and optimise treatment outcomes, particularly in high-risk populations. Increased awareness among healthcare providers and patients is essential for improving prognosis and reducing the incidence of late-stage presentations.

Purpose: Angiogenesis is engaged in endometriosis. It is regulated by regulatory factors and cytokines, transported in microvesicles. The purpose was to investigate the presence of MVs with vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP – 9) in peripheral blood and peritoneal fluid of women operated on for endometrioma or teratomaMaterial and method: Microvesicles (MVs) were determined in blood samples and peritoneal fluid samples collected from women aged 20-60 years operated on for endometriosis (test group) and teratoma (control group). The final investigations were performed on 47 patients, who qualified for the study based on the meticulous inclusion criteria. MVs were analyzed by flow cytometry (FACS) using annexin V, antibodies for molecules characteristic of cells from endometriosis foci (keratin 18 (K18), CD105, CD146), and antibodies for intraepithelial vascular growth factor VEGF and metalloproteinase - 9 (MMP - 9). The sample was double “reading” using flow cytometry (FACSCantoII). Results: Cytometry analysis confirmed MVs’ presence in plasma and peritoneal fluid collected from patients with both endometriosis and teratomas. A statistically significant higher level of AnnexinV (+) MVs were observed in plasma samples of endometriosis patients. In the control group, there was a higher percentage of double-positive VEGF (+) / MMP9 (+) and single MMP9 (+) positive MVs in the serum. In the peritoneal fluid higher frequency of double-positive VEGF (+),/MMP9 (+) MVs were found in the control group. However, the amount of VEGF (+) / MMP9 (+) MVs object did not enable to differentiate between the test and control groups. The study was the first, in which MVs were confirmed in plasma and peritoneal fluid in benign adnexa tumors. Conclusion: Microvesicles are present in peripheral blood and peritoneal fluid samples collected from patients with endometriosis and teratomas. Microvesicles with proangiogenic factors (VEGF and MMP-9) are more abundant in blood and peritoneal fluid samples from patients with teratomas.