Diagnosis and treatment of a serous cystadenofibroma-like tumor potentially arising from urinary tract endometriosis: A case report

OBJECTIVE: Urinary tract endometriosis affects 0.3-12 % of all cases of endometriosis. Medications have limited efficacy in treating advanced disease. Serous cystadenofibroma is a rare benign variant of ovarian epithelial tumors comprising both epithelial and fibrous stromal components. Its diagnosis is challenging due to its visual resemblance to malignancy. CASE REPORT: A patient diagnosed with ureteral endometriosis underwent surgical excision of the right kidney and ureter. Ten years later, the patient developed a tumor suspected to be malignant at the same site. Following exploratory laparotomy, the tumor was pathologically diagnosed as resembling serous cystadenofibroma. CONCLUSION: Differentiating a such tumors from other malignancies based solely on imaging findings is challenging. It is crucial to judge the degree of surgical intervention through intraoperative macroscopic examination and rapid pathological assessment. The efficacy of gonadotropin-releasing hormone analog (GnRHa) and dienogest (DNG) therapy in preventing the recurrence of such tumors following surgery for endometriosis remains uncertain.