HighlightsEctopic splenic tissue can be either congenital (accessory spleen) or acquired (splenosis).Accessory spleen (AS) is commonly located near the spleen’s hilum and in the pancreas tail.Pelvic AS is a very rare entity.AS is generally determined incidentally during radiological investigation or surgery.Pelvic AS may be considered in differential diagnosis of adnexal masses.

Objective:The aim of the present study was to evaluate the effects of progesterone (PG) against ovarian ischemia-reperfusion (I/R) injury through the evaluation of biochemical and histopathologic parameters.Material and Methods:Twenty-one female Wistar albino rats were divided into three groups. Group 1: Sham; group 2: I/R; group 3: I/R+PG (8 mg/kg). PG was administered intraperitoneally to the rats in group 3, 30 minutes before a detorsion operation. Ovarian I/R injury was evaluated in serum and tissue by using biochemical parameters including malondialdehyde (MDA), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, neutrophil gelatinase-associated lipocalin (NGAL) and immunofluorescence staining by using a terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay.Results:Serum and tissue TOS levels were significantly lower in group 3 than in group 2. Tissue TAS levels were higher in group 3 than in group 2 (p<0.001). NGAL and MDA levels were similar between the groups. Histologic score, including vascular congestion, hemorrhage, polymorphonuclear neutrophils, and interstitial edema, was higher in group 2. Pre-treatment with PG decreased the score, but this difference was not statistically significant. The number of apoptotic cells was higher in group 2 than in groups 1 and 3. The TUNEL-positive cell number decreased with PG in group 3.Conclusion:Preoperative PG treatment might exert protective effects on ovarian I/R injury through its anti-apoptotic and antioxidative properties.

ÖZETAdenomyozis, endometrial gland ve stroma yapısının myometriumda bulunması halidir. Lokalize formuna adenomyom denilir ve adenomyomlar leiomyomu taklit eder. Ekstrauterin adenomyom literatürde vaka sunumları olarak yer alan ve oldukça nadir görülen bir antitedir. Patolojilerinde endometrial mukoza ile döşeli santral bir kavite ve çevresinde myometrium dokusundan kalın bir duvar yapısı ile uterus benzeri kitle görünümü vardır. Ekstrauterin adenomyomlar, over, broad ligament, uterosakral ligamant ya da ekstrapelvik lokalizasyonlu olabilirler. Etyopatojenezinden müllerian kanal kapanma defekti ve subçölomik mezanşimal transformasyon sorumlu tutulmaktadır. Bu yazıda, 37 yaşında primer infertil hastada sol adneksiyal kitle nedeniyle yapılan laparoskopi sırasında ligamantum latum yaprakları arasında tespit edilen ve histopatolojik olarak ekstrauterin adenomyom tanısı alan olgu tartışılmıştır. Ayırıcı tanıda endometrioma, leiomyomatozis peritonealis, leiomyomlar, maliniteler yer almalıdır. Nadir görülse de adneksiyal kitlelerin ayırıcı tanısında ekstrauterin adenomyomlar akla gelmelidir.Anahtar Kelimeler: Adenomyozis, broad ligament, mezanşimal transformasyon. SUMMARYAdenomyosis is the presence of endometrial glands and stroma within the endometrium. Its localised form is called adenomyoma and adenomyomas mimic leiomyomas. An extrauterine adenomyoma is an extremely rare entity and take a place in the literature as case reports. Uterus like masses with thick muscle wall and endometrium-lined central cavity are seen in their pathology. Extrauterin adenomyomas can be located in ovary, broad ligament, uterosacral ligament or extrapelvic localisation. Müllerian duct fusion defect and subcoelomic mesenchyme transformation are two possible theory for etiopathogenesis of extrauterine adenomyoma. Herein, we discussed a patient 37 years old with primary infertility which was operated for left adnexial mass and detected intraligamentary mass during laparoscopy. The diagnosis was confirmed as extrauterine adenomyoma with histopathological examination. Differantial diagnosis should be done with endometrioma, leiomyomatosis peritonealis, leiomyomas and malignancies. Althought it is an extremely rare entity, extrauterine adenomyomas should be included in differential diagnosis of adnexal masses.

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