Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature

Our plain-English summary of Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature, by P. Rosenberg, L. Nappi, A. Santoro, et al (Archives of Gynecology and Obstetrics, 2011).

The study

• Authors: P. Rosenberg, L. Nappi, A. Santoro, P. Bufo, P. Greco
• Journal: Archives of Gynecology and Obstetrics
• Published: 2011;283(3):519-23
• Type of article: Case report, Systematic review
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Introduction: Endosalpingiosis is a disorder of Mullerian system characterized by benign glands lined by tubal type epithelium and involves the peritoneum, subperitoneal tissues, and retroperitoneal lymph nodes. Endosalpingiosis is almost an incidental finding on microscopic examination. Seldom it appears as a cyst and it can be confused clinically for an ovarian tumor.

Design: A case report and a systematic review about pelvic mass-like florid endosalpingiosis of the uterus from PUB MED database were performed.

Patient(s): We describe a case report of a 50-year-old woman with a pedunculated uterine neoformation, for which the preoperative exams could be compatible with an adnexal mass. Twelve patients with similar clinical history were discussed in the review.

Treatment: Laparoscopy with radical exeresis was performed.

Results: Microscopic exam revealed florid cystic endosalpingiosis of the uterus.

Conclusions: Endosalpingiosis is a rare mullerian disorder and the main problem is that the symptomatology is not specific and it may be initially misinterpreted. In relation to the papillary aspect of the lesion and focal calcifications, the histological differential diagnosis could include serous adenocarcinoma, but the lack of cellular stratification in absence of mitotic activity, and the presence of slight nuclear atypia contradict the diagnosis of carcinoma. The differential diagnosis for endosalpingiosis also includes multiple peritoneal inclusion cysts (benign cystic mesothelioma). The aim of this case report has not been only to describe the rarity of this pathology, but it contributes to consider endosalpingiosis as a possible diagnostic hypothesis for which may be indicated a conservative surgical treatment.

In plain English

This article is a case report combined with a review of earlier published cases. It concerns endosalpingiosis of the uterus, a non-cancerous condition in which glands resembling fallopian-tube lining grow outside their usual place. It is a gynecology article and does not mention asbestos. A 50-year-old woman with recurrent pelvic pain had a multilobular mass in the right adnexal area on ultrasound, and her ovarian tumor markers were negative. At laparoscopy, the surgeons found a pedunculated mass of about 10 cm growing from the back wall of the uterus. Both adnexa looked normal. The mass was removed and she went home on the second day after surgery. Under the microscope, the mass was a florid cystic lesion lined by ciliated cuboidal serous epithelium. The authors' table lists 12 earlier published cases. They named multiple peritoneal inclusion cysts, which they also called benign cystic mesothelioma, as one condition to tell apart from endosalpingiosis. The authors concluded that endosalpingiosis should be considered as a possible diagnosis for which conservative surgery may be indicated.

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 with a review of previously published cases
• Who was studied: one 50-year-old woman (gravida 2, para 2) seen at the Institute of Obstetrics and Gynecology, University of Foggia, Italy; the review table lists 12 previously published cases, aged 20 to 73
• Main results:
  • Before surgery, transvaginal ultrasound in the patient showed a multilobular mass in the right adnexal area, and her ovarian tumor markers were negative.
  • At laparoscopy, the surgeons found a pedunculated mass of about 10 cm in diameter arising from the posterior wall of the uterus.
  • Both adnexa (ovaries and tubes) appeared normal at surgery.
  • The patient's post-operative period was regular and she went home on the second day after surgery.
  • On microscopic examination, the patient's mass was a florid cystic lesion lined by ciliated cuboidal serous epithelium. It was papillary and focally calcified.
  • The authors wrote that this case was clinically similar to the few other reported cases, in which preoperative examinations seemed compatible with an adnexal tumor.
  • In the reviewed cases, pelvic pain and menorrhagia were the most common clinical signs.
  • The authors listed multiple peritoneal inclusion cysts (benign cystic mesothelioma) among the conditions to be distinguished from endosalpingiosis.
• The authors' conclusion: The authors concluded that this case should help clinicians consider endosalpingiosis as a possible diagnosis for which conservative surgical treatment may be indicated.

Topics

Medical terms in this study, explained in our Lexicon: Epithelium, Peritoneum, Systematic Review, Differential Diagnosis, Adenocarcinoma, Nuclear Atypia, Carcinoma, Mesothelioma.

Related studies

• Florid cystic endosalpingiosis of the uterus — M.K. Heatley, P. Russell (2001)
• Laparoscopic management of peritoneal mesothelioma associated with pelvic endometriosis — F.R. Nezhat, S.M. DeNoble, et al. (2010)
• Multicystic mesothelioma caused by endometriosis: 2 case reports and review of the literature — Y. Kurisu, M. Tsuji, et al. (2011)
• Multiple cystic tumors throughout the abdominal and pelvic cavity — S.C. Yu, C.H. Wu, et al. (2012)
• Multicystic mesothelioma with endometriosis — G.M. Groisman, H. Kerner (1992)
• Surgical treatment of endometriosis — F.M. Howard (2011)

Browse more research in Archives of Gynecology and Obstetrics, or return to medical research.