ABSTRACT
Resumen: ANTECEDENTES: La endometriosis polipoide describe una variante poco común de la endometriosis, con características histológicas que simulan un pólipo endometrial y posibilidad de transformación maligna. CASO CLÍNICO: Paciente de 46 años, acudió a consulta por dolor abdominal y sangrado uterino anormal. Los estudios de imagen revelaron una masa heterogénea de forma irregular, adyacente al ovario. Los análisis de sangre reportaron concentraciones elevadas de Ca-125 (75.2 U/mL). El tratamiento consistió en resección quirúrgica mediante laparotomía. El reporte de histopatología fue: endometriosis polipoide. Actualmente la paciente permanece en vigilancia médica, sin recidiva de la enfermedad. CONCLUSIONES: La endometriosis polipoide es una variante poco común de la endometriosis, con posibilidad de evolución maligna. Es importante conocer la enfermedad, con la finalidad de ofrecer el tratamiento adecuado.
Abstract: BACKGROUND: Polypoid endometriosis was first introduced in 1980. It was used to describe an uncommon variant of endometriosis with histological features simulating an endometrial polyp and may be at risk of malignant transformation. CLINICAL CASE: A 46-year-old female presented with lower abdominal pain and Abnormal uterine bleeding. Image studies revealed an irregular shaped, heterogeneous mass adjacent to the ovary. Blood tests showed an elevated CA-125 value (75.2 U/ml). Resection of the mass was performed by laparotomy and the definitive study of histopathology revealed polypoid endometriosis. Currently the patient continues in surveillance without disease recurrence. CONCLUSIONS: Polypoid endometriosis is an uncommon variant of endometriosis, with the possibility of malignant evolution. This rare form of disease should be known, in order to provide adequate treatment for the patient.
ABSTRACT
Polypoid endometriosis is an uncommon variant of endometriosis which can mimic malignancy due to its presentation as masses. We present a case of polypoid endometriosis which simulated cervical malignancy both on clinical examination and on computed tomography (CT) scanning and discuss how magnetic resonance (MR) imaging, in particular Diffusion Weighted Imaging (DWI), can help to distinguish this condition from true malignancy and avoid invasive surgery.
Subject(s)
Endometriosis , Magnetic Resonance ImagingABSTRACT
Purpose Polypoid endometriosis is an uncommon and distinctive variant of endometriosis, and its detailed histopathological features have been investigated and analysed. Methods A retrospective analysis was performed in 10 cases with polypoid endometrio-sis by comparing clinical data, histopathologic and immunohistochemical changes. Results The patients were 27 to 54 years ( mean 39. 4 years) of age. The most common clinical presentations were a pelvic mass. The intraoperative findings suggested a neoplasm. Sites of involvement in order of frequency included ovary, uterine serosa and cervix. Polypoid, pink, gray or tan masses ranged up to 9 cm in maximal dimension. On microscopic examination, the polypoid masses were composed of an admixture of endometriotic glands and stroma. Most commonly glandular architectural patterns were simple hyperplasia. Tubal epithelial metaplasia was common. The stroma was fibrous, resembling to some extent the stroma of the endometrial polyp and atypical stromal cells can be seen. Nine cases were associated with usual endometriosis. Follow-up data in nine patients indicated that all of patients were alive without evidence of re-sidual disease. The main lesion in the differential diagnosis is a mullerian adenosarcoma. Conclusion Polypoid endometriosis is a rare manifestation of endometriosis, and probably is overgrowth of local ectopic endometrium based on endometriosis. Understanding of such lesions is avoided misdiagnosing for other benign or malignant tumors on clincal, intraoperative or pathologic assesment, and influ-ences the clinical treatment.