Endosalpingiosis with concurrent endometriosis of ovary masquerading as ovarian malignancy

Endosalpingiosis is a rare gynecological disorder of müllerian origin, characterized by the presence of tubal epithelium outside the fallopian tube, which involves structures of the female genital tract, peritoneum, and sub-peritoneal tissues. Endosalpingiosis can be associated with endometriosis or endocervicosis, although it often appears alone. Authors report a case of endosalpingiosis with concurrent endometriosis in a 42-year-old P2L1 patient. The patient presented to us with complaints of heaviness in lower abdomen, a feeling a lump in the lower abdomen and low-grade fever for 15 days. On per abdominal examination, a large solid cystic mass up to 20 weeks size was felt, which was more on the left side. Cervix was normal on speculum examination, the same mass was felt on per vaginal examination, separate from the uterus, the right fornix appeared free. Patient was asked to get a set of investigations done and to review as early as possible. An exploratory laparotomy with peritoneal wash cytology, total abdominal hysterectomy, bilateral salpingo-ophorectomy with supracolic and infracolic omentectomy and bilateral pelvic lymph nodes dissection was done on 18/07/18. Per operatively, there was a large cystic mass occupying the abdominal cavity adhered to the bowel and to posterior wall of the uterus, adhesiolysis followed by staging laparotomy was done.Patient’s postoperative course was uneventful and she was discharged on the 5th day of surgery in stable condition. The final histopathology report was suggestive of endosalpingiosis with concurrent endometriosis.

Endosalpingiosis como causa de dolor pélvico crónico: reporte de un caso / Endosalpingiosis as a cause of chronic pelvic pain: a case report

RESUMEN La endosalpingiosis es una patología benigna de origen embriológico caracterizada por la presencia de epitelio tubárico en una localización ectópica; la cual debe ser considerada ante la presencia de dolor pélvico crónico. Su etiología no está clara, y su diagnóstico suele ser un hallazgo incidental durante estudios imagenológicos, laparotomía o laparoscopia, y solo es confirmado por el estudio histopatológico. Se presenta el caso de una paciente de 43 años con antecedente de esterilización quirúrgica y resección de pólipo endocervical, quien consulta por dolor pélvico crónico de 6 años de evolución, localizado en fosa iliaca derecha. Se realiza laparoscopia exploratoria con hallazgos quirúrgicos sugestivos de endosalpingiosis.

ABSTRACT Endosalpingiosis is a benign pathology of embryological origin characterized by the presence of tubal epithelium in an ectopic location; it must be considered in the presence of chronic pelvic pain. Its etiology is not clear, and its diagnosis is usually an incidental finding during imaging studies or during laparotomy or laparoscopy, and is only confirmed by the histopathological studies. We present the case of a 43-year-old patient with a history of surgical sterilization and endocervical polyp resection, who consulted for chronic pelvic pain of 6 years of evolution, located in the right iliac fossa. Exploratory laparoscopy was performed with surgical findings suggestive of endosalpingiosis

Florid Cystic Endosalpingosis with Large Pelvic Cyst:a Case Report / 中国微创外科杂志

[Summary] This paper reports a postmenopausal woman with a rare florid cystic endosalpingosis presenting as an ovarian cyst, with many cystic lesions in the pelvis.She had chronic pelvic pain and ultrasound diagnosed of multiple cystic lesions in the pelvis. Not being aware of this rare condition of endosalpingiosis,she was laparoscopically managed successfully when the condition was diagnosed at the time of operation.There are only a few reports in the literature presenting florid cystic endosalpingiosis as ovarian or pelvic mass.This paper would not only highlight this uncommon presentation,it also raises issues for discussion relating to pre-operative diagnosis,laparoscopic appearance,pathological features and the current practice of routine salpingectomy in high risk patients in order to reduce high grade serous ovarian neoplasms.

MRI Appearance of Florid Cystic Endosalpingiosis of the Uterus: a Case Report

Endosalpingiosis is a non-neoplastic proliferation of ectopic tubal epithelium. It may be found incidentally or the patients may present with chronic pelvic pain. It may resemble a gynecologic malignancy on imaging findings and clinicians and radiologists should be aware of this benign entity to render a correct diagnosis and to avoid over-treatment. We report here the MR imaging appearance of a case of florid cystic endosalpingiosis.

Florid Cystic Endosalpingiosis of the Uterus: A Case Report

A 54-year-old woman presented with vaginal bleeding. On gynecologic and radiologic examinations, bilateral cystic ovarian tumors were suspected. A laparoscopic examination revealed multiple cysts involving both the uterine horns and the posterior surface of the uterus. These were removed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Microscopically, multiple cysts were identified in the subserosal layer of the uterus, and they were lined with benign tubal type epithelium surrounded by a smooth muscle wall. These features were consistent with "florid cystic endosalpingiosis". Considering the location of the lesion, the lesion has to be distinguished from other benign cystic lesions of the uterus and adnexa, including multicystic mesothelioma, serous cystadenoma and mucinous cystadenoma. Awareness of this lesion will facilitate a correct diagnosis by both the clinician and pathologist.

M llerian-Type Gland Inclusions in Pelvic Lymph Nodes Mimicking Metastasis: A Case Report and Review of the Literature / Journal of the Korean Cancer Association, 대한암학회지

Benign lymph node inclusions are rare, and can be mistaken for metastasis. We report, herein, a case of a 50-year-old woman who underwent a hysterectomy, with a lymphadenectomy, for an endometrial carcinoma. There was no lymph node metastasis; however, the left external and common iliac lymph nodes demonstrated a few glands, consistent with M llerian-type inclusions (endosalpingiosis). Awareness of these lesions is important to avoid either unnecessary therapy or any delay in treatment. Furthermore, pelvic and aortic lymphadenectomies may be warranted, as neoplastic transformation of preexisting metaplastic tubal-type epithelium is strongly suggested. This paper presents a case of intranodal endosalpingiosis mimicking metastasis.