Florid cystic endosalpingiosis of the uterus

Our plain-English summary of Florid cystic endosalpingiosis of the uterus, by M.K. Heatley, P. Russell (Journal of Clinical Pathology, 2001).

The study

• Authors: M.K. Heatley, P. Russell
• Journal: Journal of Clinical Pathology
• Published: 2001;54(5):399-400
• Type of article: Case report
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A 73 year old woman presented with a right sided adnexal cystic mass. At laparotomy, this proved to be a benign serous ovarian cyst and an aggregation of thin walled subserosal and soft tissue cysts and spongy nodules up to 16 mm in diameter involving the side wall of the uterus and adjacent parametrium. These were removed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histologically, the cystic spaces and smaller acini were lined by benign tubo-endometrioid epithelium, with smaller areas typical of serous differentiation and rare microfoci of endocervical-type mucinous epithelium. These features indicated multidirectional Mullerian differentiation in a process that, overall, was consistent with so called florid cystic endosalpingiosis. This lesion is to be distinguished from other benign conditions including multicystic mesothelioma, endometriosis, endocervicosis, florid deep glands of the uterine cervix, and deep Nabothian cysts of the uterine cervix.

In plain English

This article was a case report about one patient, a 73 year old woman who came to doctors with lower abdominal swelling. During surgery, the surgeons found a 70 mm cyst on the right ovary. They also found many thin walled cysts and firmer nodules, up to 16 mm across, just beneath the outer surface of the right side of the uterus and in the nearby pelvic tissue. The uterus, Fallopian tubes and both ovaries were removed, and the patient recovered without complications. Under the microscope, the cysts were lined mainly by benign tubo-endometrioid epithelium. Some had a serous (tubal) lining, and rarely there were endocervical-type mucinous cells, which were seen only in lesions in the deep wall of the cervix. The authors concluded that the case most closely resembled a condition other researchers had described as florid cystic endosalpingiosis. They suggested it might be better called cystic Mullerianosis, because several types of Mullerian lining were present. They also explained how it differs from other benign conditions, including benign cystic mesothelioma. The article did not discuss asbestos or any exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient, pathology short report)
• Who was studied: One 73 year old woman with lower abdominal swelling; the article does not state where or when she was treated
• Main results:
  • At laparotomy, the patient had a 70 mm unilocular right ovarian cyst plus multiple thin walled subserosal cysts and more solid nodules along the right side of the uterus and in the adjacent parametrium and broad ligament
  • The cysts and nodules, up to 16 mm in diameter, lay beneath the uterine serosa and extended from the mid corpus to the cervix
  • The cysts were lined mainly by benign tubo-endometrioid epithelium, with some serous (tubal) lining and rarely endocervical-type mucinous cells
  • The mucinous microfoci were found only in lesions in the deep wall of the cervix
  • The lining epithelium stained for oestrogen and progesterone receptors, and the stroma showed no endometrial stromal differentiation and no recent or old haemorrhage
  • A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed, and the patient recovered uneventfully
• The authors' conclusion: The authors concluded that the case most closely resembled florid cystic endosalpingiosis as described by Clement and Young, but might be better termed cystic Mullerianosis because other types of Mullerian epithelium were present. They distinguished it from other benign lesions, including benign cystic mesothelioma (multiple peritoneal inclusion cysts).

Topics

Medical terms in this study, explained in our Lexicon: Laparotomy, Bilateral, Epithelium, Multicystic Mesothelioma (MCM).

Related studies

• Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature — P. Rosenberg, L. Nappi, et al. (2011)
• Benign cystic peritoneal mesothelioma — J.A. Schneider, E.J. Zelnick (1985)
• Peritoneal, benign, cystic mesothelioma with free-floating cysts, re-examined by new methods. A case report — O.H. Iversen, T. Hovig, et al. (1988)
• Cystic lymphangioma: an uncommon type of scrotal swelling — G. Ferguson (1954)
• Primary tumors and cysts of the heart and pericardium — H.A. McAllister (1979)
• Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management — A.M.C. Rapisarda, A. Cianci, et al. (2018)

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