Clinicopathological and immunohistological features of polypoid endometriosis

Stewart, Colin J.R.; Bharat, Chrianna

doi:10.1111/his.12755

Cited by 18 publications

(15 citation statements)

References 30 publications

(42 reference statements)

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“…Ectopic endometrial glands resembling endometrial hyperplasia were found in one of the three cases in our hospital. Although Stewart and Bharat reported no malignant findings in the 15 cases, 40 our literature review indicated that the histological findings included endometrial hyperplasia without atypia in 15 cases, simple hyperplasia with atypia in four, and well‐differentiated endometrioid carcinoma in three (Table S1). The preoperative histological findings resemble endometrial hyperplasia making it difficult to differentiate PE from endometrial hyperplasia and endometrial cancer.…”

Section: Literature Review and Discussionmentioning

confidence: 73%

Fertility preservation of polypoid endometriosis: Case series and literature review

Miyoshi

Yamaguchi

Chigusa

et al. 2021

J of Obstet and Gynaecol

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Polypoid endometriosis (PE) is a rare distinctive variant of endometriosis with morphological features resembling malignant tumors. Although a surgical procedure is usually performed for the treatment and diagnosis of PE, fertility preservation is usually desired in cases of reproductive age. However, there have been no reports of fertility-preserving treatments resulting in live births. In this study, we report three cases of PE that were diagnosed preoperatively or intraoperatively, leading to fertility preservation. Intraoperative pathological diagnosis, hysteroscopy, and hormone therapy before treatment were useful for preoperative diagnosis in the three cases. Two of the three patients got pregnant and the pregnancy progressed to a live birth. We also performed a literature review to identify the clinical characteristics indicative of the preoperative diagnosis of PE.

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Section: Literature Review and Discussionmentioning

confidence: 73%

Fertility preservation of polypoid endometriosis: Case series and literature review

Miyoshi

Yamaguchi

Chigusa

et al. 2021

J of Obstet and Gynaecol

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“…Gunawardane DN reported a 50-year-old female had a hysterectomy and bilateral salpingo-oophorectomy for adenomyosis, uterine leiomyomas, ovarian and cervical endometriosis. Nine months later, a mass between the vagina and rectum was diagnosed the Pouch of Douglas PEM [22] .But all of the 7 patients in our group were women of childbearing age, aged from 31 to 45 (38.00±1.72) years old. No such lesions were found in postmenopausal women, which may be due to the small sample size of the cases in this group or the difference in race.…”

Section: Other Cases Reported These Yearsmentioning

confidence: 75%

“…The surface is erosive or covered with a single layer of columnar, cubic, or dwarf cubic epithelium. It may be accompanied by a small amount of active epithelial hyperplasia, cystic dilatation of the gland, intensive hyperplasia of the focal glands, abundant interstitial cells in some parts, moderate atypia, nuclear mitosis, or borderline changes, metaplasia of the fallopian tube, and atypical hyperplasia, which also bring great confusion for pathological examination [22][23][24] . At present, the immunohistochemical studies on PEM mostly suggest ER(+), PR(+), and Vinmentin(++), as previously mentioned [26,29] .…”

Section: Clinicopathological Featuresmentioning

confidence: 99%

Clinical study on 7 cases of polypoid endometriosis. PEM: a mimic of malignancy, the symptoms of adenomyosis, endometrial polyps and infertility can assist in diagnosis

Zheng¹,

Xu²,

chen³

et al. 2021

Preprint

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Objective: polypoid endometriosis (PEM) is a rare type of endometriosis (EMs), which is easy to be misdiagnosed. The purpose of this paper is to investigate the clinical features and diagnostic methods of PEM. Methods:The clinical data of 7 patients with PEM who were treated at Fujian Provincial Maternity and Children’s Hospital in China within July 2017 to December 2020 period were retrospectively analyzed, and their clinical characteristics, diagnosis, treatment and prognosis were summarized. Results: The age of onset was 31-41 (38.00 ± 1.72) years. There were 5 cases with adenomyosis, 4 cases with endometrial polyps and infertility. The clinical manifestations were diverse. Most of them were pelvic mass, compression symptoms and signs, dysmenorrhea and abnormal uterine bleeding, and three of them were similar to malignant tumors. The gross pathological features were cysts, endogenous or exogenous polypoid masses, which were all composed of endometrioid glands and stromal components, but more diverse than ordinary em. All the 7 patients were confirmed by operation and pathology. Conclusion: PEM is often complicated with adenomyosis, endometrial polyps and infertility. Pathological examination is the gold standard for diagnosis. Imaging examination is easy to be misdiagnosed. Abnormal increase of CA125 can assist in diagnosis.

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“…3 Polypoid endometriosis may typically affect peri-or postmenopausal women, and hormonal factors such as tamoxifen treatment can play a role in its pathogenesis. 2,3 Actually, nearly 50% of the patients with polypoid endometriosis were on hormonal treatment at the time of diagnosis. 4 Because polypoid endometriosis may form multiple polypoid nodules in the peritoneal cavity or endometriotic cysts mimicking malignant tumors on imaging examination, at surgery, and on gross pathologic examination, preoperative diagnosis on magnetic resonance (MR) imaging is important to avoid aggressive treatment.…”

Section: Introductionmentioning

confidence: 99%

“…4 Because polypoid endometriosis may form multiple polypoid nodules in the peritoneal cavity or endometriotic cysts mimicking malignant tumors on imaging examination, at surgery, and on gross pathologic examination, preoperative diagnosis on magnetic resonance (MR) imaging is important to avoid aggressive treatment. [1][2][3] The literature on polypoid endometriosis focusing on MR imaging findings is limited to case reports. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Several MRI findings have been reported to be useful in the diagnosis of polypoid endometriosis.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging characteristics of polypoid endometriosis and review of the literature

Takeuchi

Matsuzaki

Bando

et al. 2022

J of Obstet and Gynaecol

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Aim: Polypoid endometriosis is a rare variant of endometriosis and may mimic malignancy. The purpose of this study is to evaluate magnetic resonance (MR) imaging characteristics of polypoid endometriosis for the differential diagnosis with malignancy. Methods: MR imaging findings of four histologically proven polypoid endometriosis were retrospectively evaluated with the review of the literature. Results: All polypoid endometriosis exhibited high signal intensity on T2-weighted images reflecting abundant dilated endometrial glands. Peritoneal lesions were surrounded by low signal intensity rim represented the "black rim sign" reflecting endometriotic fibrous adhesion. Two cases arising from endometriotic cysts showed transmural extension (peritoneal extension and myometrial infiltration). Endometriotic hemorrhagic foci were demonstrated in four lesions as high signal intensity on T1-weighted images and/or susceptibilityinduced signal voids on susceptibility-weighted MR sequence. Diffusion-weighted images showed high signal intensity with relatively high apparent diffusion coefficient (ADC) due to T2 shine-through effect but no diffusion restriction, and dynamic contrast-enhanced (DCE) MR imaging showed gradually increasing contrast-enhancement pattern like benign pathologies. Conclusions: Polypoid endometriosis may mimic malignancy; however, black rim sign may be a characteristic MR imaging finding for the peritoneal lesions, and no diffusion restriction and gradually increasing contrast-enhancement pattern may reflect its benign nature.

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Clinicopathological and immunohistological features of polypoid endometriosis

Cited by 18 publications

References 30 publications

Fertility preservation of polypoid endometriosis: Case series and literature review

Fertility preservation of polypoid endometriosis: Case series and literature review

Clinical study on 7 cases of polypoid endometriosis. PEM: a mimic of malignancy, the symptoms of adenomyosis, endometrial polyps and infertility can assist in diagnosis

Magnetic resonance imaging characteristics of polypoid endometriosis and review of the literature

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