A case of polypoid endometriosis contiguous with uterine adenomyosis

IWATA Ryuichi, YOKOTA Hiromi, KUROSE Sonomi, SASAMORI Hiroki, TOMITA Jyunko, TAKAHARA Tokuei, KAWABE Kouji, TAKADA Syuuichi, AOKI Syouwa

doi:10.11437/sanpunosinpo.75.284

Polypoid endometriosis is a rare endometriosis that must be differentiated from malignancy on imaging and clinical course. We report a case of a large polypoid endometriosis that appeared to have originated from adenomyosis of the uterus. The patient was 53 years old, G2P2, and had undergone right adnexectomy at age 39 for a right ovarian endometriosis cyst. The patient came to our hospital with the chief complaint of a rapidly increasing right lower abdominal mass. On internal examination, a mass the size of a newborn baby’s head was found on the right side of the uterus with poor mobility with the uterus, and MRI showed an internal honeycomb-shaped mass contiguous with the myometrium, and a high CA125 level of 532.9 U/mL, which suggested the possibility of malignancy. In response, a total abdominal hysterectomy and left adnexectomy were performed. The pelvic cavity was frozen, probably due to endometriosis, and the tumor was continuous from the right posterior wall of the uterus and tightly adhered to the surrounding tissues. Histopathological examination of the excised specimen revealed that the glandular ducts and stroma of the mass were endometriosis-like glandular ducts and stroma, leading to the diagnosis of polypoid endometriosis. However, if the clinical course and imaging features of polypoid endometriosis can be identified and used as a differential diagnosis, excessive invasion can be avoided, and appropriate treatment can be selected. [Adv Obstet Gynecol, 75(3) : 284-290, 2023 (R5.8)]

A case of polypoid endometriosis contiguous with uterine adenomyosis

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