Polypoid endometriosis: a clinicopathological analysis

Objective To study the clinical and histopathologic features,diagnosis and differential diagnosis of polypoid endometriosis. Methods Three rare cases of polypoid endometriosis were studied by microscopy, immunohistochemistry,with review of related literature. Results Two cases were 48 year-old women,and the other one was 41 years old. Case 1 presented with a nodular mass protruding from the right rear of her uterine serosa. The other two cases presented with recurrent masses with ill-defined borders in the uterine,involving the omentum and pelvic,mimicking a malignant tumor. Microscopically,all of the cases were composed of endometriotic glands and stroma. Case 1 simulated to endometriotic polyp,with simple or complex hyperplasia,and some atypical glands and foci of marked atypical stroma. Cases 2 and 3 demonstrated that most glands were lined by endocervical or intestinal epithelia,some glands were dilated and filled with mucous,mucous lake came into being in the stroma,with myometrial invasion,and usual endometriosis could be seen in some areas. The similar lesion also involed the omentum in Case 2. Cases 1 and 3 were untreated postoperatively,and Case 2 underwent 2 courses of chemotherapy. Three cases were alive after 7,3 and 28 months of follow-up. Conclusions Polypoid endometriosis is a rare manifestation of endometriosis that may be mistaken for a neoplasm on clinical,intraoperative,or pathologic assessment,and it most commonly ocurs in postmenopausal women. Some cases may evolve into a borderline tumor,whose prognosis is good. Hormonal factors may play a role in its pathogenesis.