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Polypoid Endometriosis.

A 58-year-old postmenopausal woman with a 15-cm complex cystic right adnexal mass, uterine prolapse, and a large cystocele presented for a laparoscopy, total vaginal hysterectomy, bilateral salpingo-oophorectomy, and anterior and posterior colporrhaphy. She was on un-opposed estrogen therapy for several years. Her past medical history was significant for borderline hypertension and interstitial cystitis.

Intraoperative findings included a 15-cm right adnexal cyst with approximately 500 mL clear fluid; a 10 X 7 X 4.5-cm uterus with anterior, small, subserosal fibroid; and normal left adnexa.

Gross pathologic findings included a benign endometrial polyp (Figure 1, white arrow), adenomyosis, and leiomyomata in the uterus, while the right ovary contained endometriosis, a simple serous cyst (Figure 1, black arrow), and a benign fibroma. The right adnexal soft tissue contained scattered polypoid nodules (Figure 1, arrow-head), which represented polypoid endometriosis (Figure 2) on microscopic examination.

[ILLUSTRATIONS OMITTED]

Polypoid endometriosis is a rare manifestation of endometriosis that can be confused with a neoplasm on clinical, intraoperative, and pathologic examination. In some cases, polypoid endometriosis may be associated with un-opposed estrogen therapy and may be the site of precancerous changes or, rarely, a neoplasm. In this case, the endometrial proliferation may be explained by the unopposed estrogen therapy and the presence of a benign fibroma in the right ovary with hormonal production.

Accepted for publication February 26, 2001.

From the Department of Pathology and Laboratory Medicine, University of California Los Angeles Medical Center.

Reprints: Sathima Natarajan, MD, Department of Pathology and Laboratory Medicine, UCLA Medical Center, 10833 Le Conte Ave, Los Angeles, CA 90095-1732 (e-mail: snataraj@mednet.ucla.edu).
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Author:Chang, Andrea; Natarajan, Sathima
Publication:Archives of Pathology & Laboratory Medicine
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2001
Words:263
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