Polypoid endometriosis with endometrioid intraepithelial neoplasia mimicking malignancy: a rare case of a postmenopausal pelvic mass

Austin T Jones, Charles M. Quick, Quick CM, Monique A. Spillman, Spillman MA
Proceedings (Baylor University. Medical Center) · 2026 · vol. 39(5) , pp. 1–4 · doi:10.1080/08998280.2026.2646072 · PMID:42658175 · PMC13523947 · W7143423630
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This case report describes a rare instance of a postmenopausal pelvic mass presenting as polypoid endometriosis with endometrioid intraepithelial neoplasia, which mimicked malignancy.

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This case report describes a postmenopausal woman with an incidental complex adnexal mass and elevated tumor markers, initially raising suspicion for malignancy. Surgical removal revealed polypoid endometriosis containing areas of endometrioid intraepithelial neoplasia, highlighting the condition's potential to mimic cancer and harbor premalignant changes. The authors emphasize that definitive diagnosis requires permanent histopathology rather than frozen sections, as the presence of intraepithelial neoplasia impacts postoperative management. This paper is centrally about endometriosis — specifically the rare polypoid variant and its association with intraepithelial neoplasia in a postmenopausal patient.

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Abstract

Polypoid endometriosis is a rare variant characterized by mass-forming endometriosis, often mimicking malignancy. This report describes the case of a postmenopausal woman who presented with an incidental complex adnexal mass and elevated tumor markers. She underwent bilateral salpingo-oophorectomy and mass removal. Frozen section suggested endometriosis with possible serous borderline tumor, prompting staging. Final pathology revealed polypoid endometriosis with areas of endometrioid intraepithelial neoplasia. Polypoid endometriosis may present as a postmenopausal pelvic mass with elevated tumor markers and can contain endometrioid intraepithelial neoplasia.
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Abstract Polypoid endometriosis is a rare variant characterized by mass-forming endometriosis, often mimicking malignancy. This report describes the case of a postmenopausal woman who presented with an incidental complex adnexal mass and elevated tumor markers. She underwent bilateral salpingo-oophorectomy and mass removal. Frozen section suggested endometriosis with possible serous borderline tumor, prompting staging. Final pathology revealed polypoid endometriosis with areas of endometrioid intraepithelial neoplasia. Polypoid endometriosis may present as a postmenopausal pelvic mass with elevated tumor markers and can contain endometrioid intraepithelial neoplasia. KEY POINTS Polypoid endometriosis is a rare, mass-forming variant that can closely mimic gynecologic malignancy in peri- and postmenopausal patients. Definitive diagnosis of polypoid endometriosis requires permanent histopathology. Polypoid endometriosis may present with elevated CA-125 and CA 19-9. Polypoid endometriosis can harbor endometrioid intraepithelial neoplasia, which carries premalignant implications that influence postoperative estrogen management and surveillance. Disclosure statement/Funding The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report.

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Condition tags

endometriosis

MeSH descriptors

Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (12)

SciLite annotations

chemicals 4
estrogen estrogen tamoxifen estradiol
organisms 1
human papillomavirus

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