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Intraoperative Appearance of Endosalpingiosis: A Single-Center Experience of Laparoscopic Findings and Systematic Review of Literature. J Clin Med 2022; 11:jcm11237006. [PMID: 36498581 PMCID: PMC9738105 DOI: 10.3390/jcm11237006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a significant association with gynecologic malignancies, many underlying principles remain unclear. This work aimed to systematically describe the intraoperative appearance of endosalpingiosis. Methods: Data and intraoperative videos of patients with histologically verified endosalpingiosis were retrospectively reviewed. The main outcome measures were macroscopic phenotype and anatomical distribution. Additionally, a systematic review searching PubMed (Medline) and Embase was conducted. Results: In the study population (n = 77, mean age 40.2 years (SD 16.4)), the mean size of lesions was 3.6 mm and the main visual pattern was vesicular (62%). The most frequent localization was the sacrouterine ligaments (24.7%). In the systematic review population (n = 1174 (210 included studies overall), mean age 45.7 years (SD 14.4)), there were 99 patients in 90 different studies with adequate data to assess the appearance of the lesions. The mean size of the lesions was 48.5 mm, mainly with a cystic visual pattern (49.5%). The majority of the lesions affected the ovaries (23.2%), fallopian tubes (20.4%), or lymph nodes (18.5%). Comparing this study to the literature population, the main differences concerned the size (p < 0.001) and main visual patterns (p < 0.001) of lesions. Conclusions: The usual intraoperative findings of endosalpingiosis appeared less impressive than described in the literature. In our study population, lesions of a few millimeters in size with a vesicular appearance were mostly seen, most frequently in the sacrouterine ligament area. Intraoperative recognition by the gynecologic surgeon and histologic diagnosis should play an important role in further understanding this entity, scientifically and clinically.
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Yang M, Li Y, Chen M, Chen J, Kung FT. Uterine endosalpingiosis: Case report and review of the literature. Taiwan J Obstet Gynecol 2019; 58:324-327. [PMID: 31122517 DOI: 10.1016/j.tjog.2019.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Endosalpingiosis rarely occurs in the uterus. We report a case and review literature to explore its current clinical diagnosis and treatment. CASE REPORT A 31-year-old woman was admitted to the hospital for suspected uterine leiomyoma with cystic degeneration based on ultrasound and magnetic resonance imaging and surgical treatment. Laparoscopy revealed a large cystic mass protruding from the posterior uterine wall. The mass was resected, and a histologic examination showed that the cyst wall was lined with benign fallopian tube-type ciliated epithelium surrounded by normal myometrium, consistent with the diagnosis of endosalpingiosis of the uterus (also known as a Müllerian cyst). Currently, there are 18 cases (including ours) in the literature. Of these, two had a uterine malignancy, one endometrioid endometrial carcinoma, and another cervical adenocarcinoma. The age at diagnosis varied from 31 to 73, with a mean of 47 ± 8. The typical clinical manifestations were a palpable low abdominal mass, abnormal menstrual bleeding, and pelvic pain. Overall, 75% (12 of 16) of patients underwent a total hysterectomy, while 62.5% (10 in 16) had a concomitant bilateral salpingo-oophorectomy for nonmalignancy. No recurrence was reported. CONCLUSION We describe the youngest patient with tumor-like uterine endosalpingiosis. The preoperative diagnosis is challenging because of its rarity. Most patients had a hysterectomy with castration, which may have resulted in overtreatment. Awareness of this lesion is necessary for the differential diagnosis of uterine and adnexal tumors. Review of relevant literature has shown a relationship between endosalpingiosis progression and cancer development, indicating an uncertain and complicated pathology.
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Affiliation(s)
- Meilin Yang
- Department of Obstetrics and Gynecology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China
| | - Yuqin Li
- Department of Obstetrics and Gynecology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China.
| | - Mengkun Chen
- Department of Obstetrics and Gynecology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China
| | - Jowei Chen
- Department of Obstetrics and Gynecology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China
| | - Fu-Tsai Kung
- Department of Obstetrics and Gynecology, Xiamen Chang Gung Hospital, Xiamen, 361022, Fujian, China; Department of Obstetrics and Gynecology, Kaoshiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
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Im S, Jung JH, Choi HJ, Kang CS. Intramural florid cystic endosalpingiosis of the uterus: a case report and review of the literature. Taiwan J Obstet Gynecol 2015; 54:75-7. [PMID: 25675925 DOI: 10.1016/j.tjog.2014.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2013] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE We report a case of intramural florid cystic endosalpingiosis in the lower uterine segment of the uterus. CASE REPORT A 43-year-old female presented with vaginal bleeding. Abdominal computed tomography suggested a leiomyoma with cystic degeneration. A total hysterectomy revealed a 4.0 cm × 3.8 cm cystic mass in the lower uterine segment. The cystic space microscopically was lined with a single layer or stratified layer of ciliated columnar cells that resembled tubal epithelium without cytologic atypia. The glandular spaces were surrounded by normal myometrium with no evidence of periglandular endometrial stroma, which was consistent with the diagnosis of florid cystic endosalpingiosis. CONCLUSION Florid cystic endosalpingiosis involving the uterus is a rare and clinically unexpected finding; however, it should be considered in the differential diagnosis of a uterine mass.
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Affiliation(s)
- Soyoung Im
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Han Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Hyun Joo Choi
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Suk Kang
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Singhania N, Janakiraman N, Coslett D, Ahmad N. Endosalpingiosis in conjunction with ovarian serous cystadenoma mimicking metastatic ovarian malignancy. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:361-3. [PMID: 25180540 PMCID: PMC4159242 DOI: 10.12659/ajcr.890921] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Patient: Female, 26 Final Diagnosis: Endosalpingiosis Symptoms: Chronic pelvic pain Medication: — Clinical Procedure: Diagnostic laproscopy (conservative management) Specialty: Obstetrics and Gynecology
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Affiliation(s)
- Namrata Singhania
- Department of Family Medicine, Wright Center for Graduate Medical Education, Wilkes Barre, USA
| | - Neha Janakiraman
- Department of Family Medicine, Wright Center for Graduate Medical Education, Wilkes Barre, USA
| | - Douglas Coslett
- Department of Obstetrics and Gynecology, Wilkes Barre General Hospital, Wilkes Barre, USA
| | - Navid Ahmad
- Department of Pathology, Wilkes Barre General Hospital, Wilkes Barre, USA
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Park J, Kim TH, Lee HH, Chung SH, Jeon DS. Endosalpingiosis in postmenopausal elderly women. J Menopausal Med 2014; 20:32-4. [PMID: 25371889 PMCID: PMC4217568 DOI: 10.6118/jmm.2014.20.1.32] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 12/04/2013] [Accepted: 01/12/2014] [Indexed: 11/18/2022] Open
Abstract
In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.
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Affiliation(s)
- Junsik Park
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Tae-Hee Kim
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hae-Hyeog Lee
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Soo-Ho Chung
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Dong-Su Jeon
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Patonay B, Semer D, Hong H. Florid cystic endosalpingiosis with extensive peritoneal involvement and concurrent bilateral ovarian serous cystadenoma. J OBSTET GYNAECOL 2011; 31:773-4. [PMID: 22085078 DOI: 10.3109/01443615.2011.608865] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- B Patonay
- Department of Pathology and Laboratory Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina 27858, USA
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Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature. Arch Gynecol Obstet 2010; 283:519-23. [DOI: 10.1007/s00404-010-1700-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Accepted: 09/21/2010] [Indexed: 10/19/2022]
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Suarez-Vilela D, Izquierdo-Garcia FM, Mendez-Alvarez JR, Dominguez-Iglesias F. Florid cystic endosalpingiosis inside a uterine subserous leiomyoma. Pathology 2009; 41:401-3. [PMID: 19404860 DOI: 10.1080/00313020902884998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cil AP, Atasoy P, Kara SA. Myometrial involvement of tumor-like cystic endosalpingiosis: a rare entity. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:106-110. [PMID: 18570219 DOI: 10.1002/uog.5346] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Endosalpingiosis is characterized by the presence of benign glands lined by tubal-type epithelium involving the pelvic and lower abdominal peritoneum and pelvic and para-aortic lymph nodes in women. Rarely, cystification can occur, resulting in a neoplasm-like mass associated with clinical manifestations, an intraoperative abnormality, or a striking finding on gross examination. Here we report the transvaginal ultrasound, magnetic resonance imaging and histopathological appearance of an unusual case of cystic endosalpingiosis involving the right ovary and full thickness of the wall of the uterine fundus in a patient who presented with a 6-month history of menorrhagia and pelvic pain. Clinicians should be aware of this type of uterine benign manifestation so as to refrain from overtreatment.
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Affiliation(s)
- A P Cil
- Department of Obstetrics and Gynecology, Kirikkale University School of Medicine, Kirikkale, Turkey.
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Youssef AH, Ganesan R, Rollason TP. Florid cystic endosalpingiosis of the uterus: a case report. Histopathology 2007. [DOI: 10.1111/j.1365-2559.2007.02828.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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