Appendiceal endosalpingiosis: clinical presentation and imaging appearance of a rare condition of the appendix

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This paper describes the clinical presentation and imaging appearance of appendiceal endosalpingiosis, a rare condition characterized by benign fallopian tubal-like epithelium mimicking appendicitis or appendiceal tumors.

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Abstract

Endosalpingiosis rarely affects the appendix but can be mistaken for acute appendicitis or appendiceal tumors. The medical literature regarding appendiceal endosalpingiosis is sparse; consisting of only four case reports which are primarily focused on the histopathology but provide little radiologic correlation. Endosalpingiosis is a rare condition characterized by the presence of benign fallopian tubal-like glandular epithelium derived from Mullerian ducts, usually affecting the serosal surfaces of the pelvis and peritoneum. It is histologically differentiated from endometriosis as endosalpingiosis lacks endometrial stroma. Endosalpingiosis tends to affect older women and has been associated with ovarian serous tumors of low malignant potential. After a retrospective review of a pathology database, we present pathologically proven cases of appendiceal endosalpingiosis with correlative imaging. We discuss the clinical presentation, illustrate the CT and MRI appearance, histologic characteristics, and review the current medical literature of appendiceal endosalpingiosis.
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Abstract

Endosalpingiosis rarely affects the appendix but can be mistaken for acute appendicitis or appendiceal tumors. The medical literature regarding appendiceal endosalpingiosis is sparse; consisting of only four case reports which are primarily focused on the histopathology but provide little radiologic correlation. Endosalpingiosis is a rare condition characterized by the presence of benign fallopian tubal-like glandular epithelium derived from Mullerian ducts, usually affecting the serosal surfaces of the pelvis and peritoneum. It is histologically differentiated from endometriosis as endosalpingiosis lacks endometrial stroma. Endosalpingiosis tends to affect older women and has been associated with ovarian serous tumors of low malignant potential. After a retrospective review of a pathology database, we present pathologically proven cases of appendiceal endosalpingiosis with correlative imaging. We discuss the clinical presentation, illustrate the CT and MRI appearance, histologic characteristics, and review the current medical literature of appendiceal endosalpingiosis. Similar content being viewed by others

References

Prentice L, Stewart A, Mohiuddin S, Johnson NP (2012) What is endosalpingiosis? Fertil Steril 98(4):942–947. https://doi.org/10.1016/j.fertnstert.2012.06.039 Pollheimer MJ, Leibl S, Pollheimer VS, Ratschek M, Langner C (2007) Cystic endosalpingiosis of the appendix. Virchows Arch 450(2):239–241. https://doi.org/10.1007/s00428-006-0328-9 Demir MK, Savas Y, Furuncuoglu Y, et al. (2017) Imaging findings of the unusual presentations, associations and clinical mimics of acute appendicitis. Eurasian J Med 49(3):198–203. https://doi.org/10.5152/eurasianjmed.2017.17218 Sampson JA (1930) Post salpingectomy endometriosis (endosalpingiosis). Am J Obstet Gynecol 20:443–480 Tallón-Aguilar L, Olano-Acosta C, López-Porras M, Flores-Cortés M, Pareja-Ciuró F (2009) Endosalpingiosis of the appendix. Cir Esp 85(6):383. https://doi.org/10.1016/j.ciresp.2008.09.017 Djordjevic B, Clement-Kruzel S, Atkinson NE, Malpica A (2010) Nodal endosalpingiosis in ovarian serous tumors of low malignant potential with lymph node involvement: a case for a precursor lesion. Am J Surg Pathol 34(10):1442–1448. https://doi.org/10.1097/PAS.0b013e3181f17d33 Katre R, Morani AK, Prasad SR, et al. (2010) Tumors and pseudotumors of the secondary Mullerian system: review with emphasis on cross-sectional imaging findings. AJR 195(6):1452–1459. https://doi.org/10.2214/AJR.10.4302 Esselen KM, Terry KL, Samuel A, et al. (2016) Endosalpingiosis: more than just an incidental finding at the time of gynecologic surgery? Gynecol Oncol 142(2):255–260. https://doi.org/10.1016/j.ygyno.2016.05.036 Irving JA, Young RH, Clement PB (2015) Sternberg’s diagnostic surgical pathology, 6th edn. The Netherlands: Wolters Kluwer Health Kaneda S, Fujii S, Nosaka K, et al. (2015) MR imaging findings of mass-forming endosalpingiosis in both ovaries: a case report. Abdom Imaging 40(3):471–474. https://doi.org/10.1007/s00261-014-0327-2 Cajigas A, Axiotis CA (1990) Endosalpingiosis of the vermiform appendix. Int J Gynecol Pathol 9(3):291–295 Ryuko K, Miura H, Abu-Musa A, Iwanari O, Kitao M (1992) Endosalpingiosis in association with ovarian surface papillary tumor of borderline malignancy. Gynecol Oncol 46(1):107–110 Author information Authors and Affiliations Corresponding author Ethics declarations Funding No grants or funding was involved in this project. Conflict of interest All authors (Drs. Tudor, Williams, Myers and Umar) declare no conflicts of interest. Ethical approval The study is a retrospective review of the medical record and is compliant with Henry Ford. Hospital’s Institutional Review Board guidelines (IRB# 12225) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study (retrospective review) formal consent is not required. Informal consent This article does not contain studies with human or animal participants performed by any of the authors. Rights and permissions About this article Cite this article Tudor, J., Williams, T.R., Myers, D.T. et al. Appendiceal endosalpingiosis: clinical presentation and imaging appearance of a rare condition of the appendix. Abdom Radiol 44, 3246–3251 (2019). https://doi.org/10.1007/s00261-018-1813-8 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-018-1813-8

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Condition tags

endometriosis

MeSH descriptors

Appendix Cecal Diseases Endometriosis Fallopian Tube Diseases Magnetic Resonance Imaging Tomography, X-Ray Computed Adult Appendectomy Appendix Cecal Diseases Contrast Media Diagnosis, Differential Endometriosis Fallopian Tube Diseases Female Humans Iopamidol

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