Polypoid Endometriosis of the Uterine Cervix With Arias-Stella Reaction in a Patient Taking Phytoestrogens

Ana Félix, Francisco F. Nogales, Nogales FF, Arias-Stella J, Javier Arias-Stella, Javier Arias‐Stella
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2010 · vol. 29(2) , pp. 185–188 · doi:10.1097/pgp.0b013e3181b7015e · PMID:20173505 · W2003285525
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This case report describes polypoid cervical endometriosis with an Arias-Stella reaction in a patient taking phytoestrogens, presenting unique histological features that initially mimicked papillary serous carcinoma.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-20 · read from full text ⓘ

This case report describes a 48-year-old woman with a history of tubal ligation who presented with a 2.5 cm polypoid endometriotic lesion in the uterine cervix. The tissue exhibited unusual metaplastic changes and a prominent Arias-Stella reaction, which occurred despite the absence of pregnancy and was likely linked to phytoestrogen treatment. Initial biopsy results erroneously suggested papillary serous carcinoma due to the atypical histology, but subsequent immunohistochemical analysis confirmed the benign nature of the endometriosis by identifying endometrial-type stroma and ruling out malignancy markers. This paper is centrally about endometriosis — specifically a rare presentation of polypoid cervical endometriosis with an Arias-Stella reaction.

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Abstract

We report for the first time a case of 2.5 cm polypoid cervical endometriosis with a superficial growth pattern in a 48-year-old patient with past tubal ligation. The lesion showed metaplastic changes (clear cell, eosinophilic, micropapillary) and a prominent Arias Stella reaction in the absence of concomitant pregnancy but presumably related to phytoestrogenic treatment. The eutopic endometrium, however, had a usual proliferative appearance, implying that it showed a different response from the endometriotic tissues, suggesting the possibility of a metaplastic origin for the endocervical polypoid endometriosis. The unusual histology of the lesion led to an erroneous diagnosis of papillary serous carcinoma in the biopsy. This was subsequently excluded on finding endometrial-type stroma surrounding glands, and was confirmed immunohistochemically by a low Ki-67 index and negativity for p53.
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Polypoid Endometriosis of the Uterine Cervix With Arias-Stella Reaction in a Patient Taking Phytoestrogens - Ana Félix - Francisco F. Nogales - Javier Arias-Stella We report for the first time a case of 2.5 cm polypoid cervical endometriosis with a superficial growth pattern in a 48-year-old patient with past tubal ligation. The lesion showed metaplastic changes (clear cell, eosinophilic, micropapillary) and a prominent Arias Stella reaction in the absence of concomitant pregnancy but presumably related to phytoestrogenic treatment. The eutopic endometrium, however, had a usual proliferative appearance, implying that it showed a different response from the endometriotic tissues, suggesting the possibility of a metaplastic origin for the endocervical polypoid endometriosis. The unusual histology of the lesion led to an erroneous diagnosis of papillary serous carcinoma in the biopsy. This was subsequently excluded on finding endometrial-type stroma surrounding glands, and was confirmed immunohistochemically by a low Ki-67 index and negativity for p53.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Phytoestrogens Uterine Cervical Diseases Uterine Cervical Neoplasms Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Histocytochemistry Humans Middle Aged Phytoestrogens Uterine Cervical Diseases Uterine Cervical Diseases Uterine Cervical Diseases Uterine Cervical Neoplasms Uterine Cervical Neoplasms Uterine Cervical Neoplasms

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