Endometriosis infiltrating the pelvic floor muscles with histopathological correlation—A case report

Crispi, C.P.; Crispi, Fernanda de Paula; Cardeman, Leon; Salomão, Alice Cristina Coelho Brandão; Fonseca, Márlon de Freitas

doi:10.1111/jog.14056

Cited by 6 publications

(3 citation statements)

References 9 publications

(10 reference statements)

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“…Other locations also include the intestine, abdominal wall, vagina, cervix, bladder, ureter, pelvic oor muscles, and recto-vaginal septum. [2][3][4] [5][6] [7] Malignant transformation from adenomyosis is extremely rare. [8] [9][10] [11] The most common malignant pathological type in ectopic endometrium is endometrioid adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrical deep endometriosis

Zhou,

Luo,

Tang

et al. 2024

Preprint

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Background Carcinomatous changes from the ectopic endometrial glands in endometriosis have been reported in many studies, but malignant transformation from uterine adenomyosis/adenomyoma is rare. And clear cell-like adenocarcinoma represents a seldom-encountered malignant pathological variant of ectopic endometrium. Case presentation This case report presents a case of a 44-year-old nulliparous woman begun with abdominal pain and intestinal obstruction. Past medical history showed laparoscopic ovarian endometriotic cyst excision. Ultrasound indicated adenomyoma and a parametrical hypoechoic nodule with abundant blood flow signals and unclear boundaries. Deep invasive endometriosis was considered preoperatively. The patient underwent laparoscopic subextensive hysterectomy and bilateral adnexa resection. Chocolate cyst-like lesion was observed in the parametral lesion. Postoperative pathological examinations suggested endometrioid adenocarcinoma arising from eutropic endometrium and adenomyoma. Left parametrical lesions suggested poorly differentiated endometrioid adenocarcinoma combined with clear cell carcinoma. CD10 + endometrial stromal cells were observed surrounding tumor cell masses. The patient underwent subsequent transabdominal tumor cell reduction surgery and chemotherapy. Combined with surgical founding and pathological characters of the left parametrical adenocarcinoma, the parametrial lesions were more likely to be carcinomatous changes of the original deep endometriosis. Conclusion We herein present a rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrical deep endometriosis that may help inspire additional studies in the future.

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Section: Introductionmentioning

confidence: 99%

A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrical deep endometriosis

Zhou,

Luo,

Tang

et al. 2024

Preprint

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“…Endometriosis of the skeletal muscular system (ESMS) is defined as the presence of endometrial glands or stromal cells in skeletal muscles, bones, or joints. To date, beyond the head muscles, cases with ESMS have been reported in the trunk muscles, extremities muscles, pelvis muscles, and limb joints, including the trapezius muscle [ 9 ], deltoid muscle [ 10 , 11 ], rectus abdominis [ 12 – 39 ], obliquus externus abdominis [ 40 , 41 ], pyramidalis [ 42 ], psoas major muscle and iliopsoas muscle [ 43 – 47 ], piriformis muscle [ 48 – 51 ], internal obturator muscle [ 52 , 53 ], gluteus muscle [ 54 – 59 ], Levator ani and coccygeus [ 60 , 61 ], vastus lateralis muscle [ 62 – 65 ], thigh adductor muscle and gracilis [ 66 ], biceps femoris muscle [ 67 , 68 ], soleus and gastrocnemius [ 69 ], shoulder joint [ 70 ], wrist joint [ 71 ], and knee joint [ 72 , 73 ]. ESMS has highly variable manifestations due to the heterogeneity of lesion location; the symptoms are usually atypical, the pain is often not proportional to the size of the lesion, and sometimes ESMS does not coexist with pelvic endometriosis, which may lead to misdiagnosis or delayed diagnosis, prolonged therapy, or impaired function of the patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Endometriosis of the skeletal muscular system (ESMS): a systematic review

Shen

Quan

et al. 2023

BMC Women's Health

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Background Extrapelvic endometriosis occurring at skeletal muscle and joint sites is not rare and is prone to delayed diagnosis and inappropriate treatment. Herein, endometriosis of the skeletal muscular system (ESMS) is systematically reviewed to facilitate early diagnosis and treatment. Methods Literature on ESMS published before March 2022 was retrieved from the Ovid Medline and Web of Science databases, and the major clinical data were extracted for descriptive analysis. Results A total of 62 studies (78 ESMS cases) met these requirements. The ESMS included the abdominal muscles (50.7%), pelvic floor muscles (11.6%), lower limb muscles (11.6%), hip muscles (8.7%), lumbar muscles (7.2%), joints (5.8%), upper limb muscles (2.9%), and shoulder–neck muscles (1.4%). The age was 34.0 ± 7.2 years (range 17–49 years). Approximately 63.8% of patients had at least one previous pelvic surgery, and 76.8% of local symptoms were related to the menstrual cycle. The course of disease was 29.6 ± 25.4 months (range 0.5–96 months). Only 30.3% of the patients sought initial medical advice from gynecologists, while 69.7% sought initial medical advice from a nongynecological physician. Twenty-seven patients underwent fine-needle aspiration (FNA) under ultrasound or CT monitoring, and only 44.4% (12/27) were confirmed to have endometriosis by FNA tissue pathology. Approximately 47.4% (37/78) of the patients had a normal pelvic cavity appearance. Surgical resection was performed in 92.3% (72/78) of the patients, of whom 88.9% (64/72) underwent complete resection of the lesion (negative surgical margin) and 20.8% (15/72) received postoperative hormone therapy. At 16.7 months of follow-up, 83.3%, 13.8%, 2.9%, and four patients had complete response, partial response, recurrence, and permanent function impairment, respectively. Conclusion Endometriosis can occur at almost any site in the musculoskeletal system. For women of reproductive age with catamenial pain or a mass in the musculoskeletal system, endometriosis should be suspected. Fine-needle aspiration can easily lead to missed diagnoses. Surgical resection for negative margins is the main treatment, and permanent impairment of function may occur in a few patients due to delayed diagnosis. Vascular lymphatic metastasis is the most likely mechanism of pathogenesis.

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“…Other locations also include the intestine, abdominal wall, vagina, cervix, bladder, ureter, pelvic oor muscles, and recto-vaginal septum. [2][3][4][5][6][7] Malignant transformation from adenomyosis is extremely rare. [8][9][10][11] The most common malignant pathological type in ectopic endometrium is endometrioid adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Combined Endometrioid Adenocarcinoma Arising from Uterine Adenomyosis and Clear Cell Carcinoma Arising from Parametrial Deep Endometriosis

Huang

Luo

2021

Preprint

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Background: Simultaneously malignant transformation from both uterine adenomyoma and deep endometriotic lesions is very rare. Case presentation: We present a case of a 44-year-old nulliparous woman begun with abdominal pain and intestinal obstruction. Past medical history showed laparoscopic ovarian endometriotic cyst excision. Ultrasound indicated adenomyoma and a parametrial hypoechoic nodule with abundant blood flow signals and unclear boundaries. Deep invasive endometriosis was considered preoperatively. The patient underwent laparoscopic subextensive hysterectomy and bilateral adnexa resection. Chocolate cyst-like lesion was observed in the parametiral lesion. Postoperative pathological examinations suggested endometrioid adenocarcinoma arising from eutopic endometrium and adenomyoma. Left parametrial lesions suggested poorly differentiated endometrioid adenocarcinoma combined with clear cell carcinoma. CD10+ endometrial stromal cells was observed surrounding tumor cell masses. The patient underwent subsequent transabdominal tumor cell reduction surgery and chemotherapy.Conclusion: Combined with surgical founding and pathological characters of the left parametrial adenocarcinoma, it was more likely to be carcinomatous changes of the original deep endometriosis.

show abstract

Endometriosis infiltrating the pelvic floor muscles with histopathological correlation—A case report

Cited by 6 publications

References 9 publications

A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrical deep endometriosis

A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrical deep endometriosis

Endometriosis of the skeletal muscular system (ESMS): a systematic review

A Rare Case of Combined Endometrioid Adenocarcinoma Arising from Uterine Adenomyosis and Clear Cell Carcinoma Arising from Parametrial Deep Endometriosis

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