Endocervicosis of the Uterine Cervix

Abstract

Endocervicosis is considered a form of Mülleriosis affecting mainly the bladder and is comprised of endocervical-type glands and cysts. It has been rarely described in the uterine cervix where the extensive involvement of cervical and paracervical tissue poses the suspicion of malignancy, mostly minimal-deviation adenocarcinoma. We describe a case of cervical endocervicosis causing long-term symptoms leading to hysterectomy. We provide evidence that this pathology is associated with cesarean section similar with isthmocele. Its differential diagnosis is discussed.

Diagnostic dilemma in cervical endocervicosis

“…According to its histogenesis, endocervicosis is the rarest of the Müllerian lesions and is thought to originate from the pelvic peritoneum or retroperitoneum [ 1 ]. Endocervicosis is one of the pseudoneoplastic glandular lesions and is characterized by an uneven arrangement of glands lined by a benign mucinous endocervical-type epithelium, often cystically dilated and occupying the cervical wall and extending to the paracervical tissue [ 2 4 ]. It has primarily been described in the urinary bladder [ 5 ] and rarely in the cervix [ 2 ], axillary lymph nodes [ 6 ], rectum [ 7 ], and mesosalpinx [ 8 ].…”

“…Endocervicosis is one of the pseudoneoplastic glandular lesions and is characterized by an uneven arrangement of glands lined by a benign mucinous endocervical-type epithelium, often cystically dilated and occupying the cervical wall and extending to the paracervical tissue [ 2 4 ]. It has primarily been described in the urinary bladder [ 5 ] and rarely in the cervix [ 2 ], axillary lymph nodes [ 6 ], rectum [ 7 ], and mesosalpinx [ 8 ]. Interestingly, one report referred to its association with a mechanical etiology, like that seen in isthmocele, rather than that of Müllerianosis [ 2 ].…”

“…It has primarily been described in the urinary bladder [ 5 ] and rarely in the cervix [ 2 ], axillary lymph nodes [ 6 ], rectum [ 7 ], and mesosalpinx [ 8 ]. Interestingly, one report referred to its association with a mechanical etiology, like that seen in isthmocele, rather than that of Müllerianosis [ 2 ].…”

“…It is a benign disease that does not require additional treatment after surgical resection [ 9 ]. However, in the initial diagnosis of pseudoneoplastic glandular lesions of the uterine cervix, benign diseases, like adenomyoma and endocervicosis, and premalignant or even malignant lesions, including adenoma malignum and carcinoma of the cervix, should also be considered [ 2 9 10 ]. The treatment for the above-mentioned diseases is very different.…”

“…Endocervicosis is the rarest of the four Müllerian lesions, and it primarily affects the bladder. However, this pseudoneoplastic lesion has also been documented in other locations [ 2 ].…”