Endometriotic cyst in the mesosalpinx: a case report and review of the literature.

Takuto Shimamura, Noriyoshi Oki, Ryo Yamasaki, Yoko Kashima, Keisuke Ogimoto, Yuka Ejima, Ko Shimogawa, Shigeki Yoshida
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2021 · vol. 37(1) , pp. 176–183 · doi:10.5180/jsgoe.37.1_176 · W3166705087
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

This case report describes a rare mesosalpingeal endometriotic cyst and reviews literature, suggesting coelomic metaplasia theory involving peritoneal mesothelium transitioning to Müllerian-type epithelium contributes to its pathogenesis.

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This paper reports a rare case of an endometriotic cyst located in the mesosalpinx of a 36-year-old multiparous woman, detected by MRI as a 6 cm right adnexal cyst and confirmed by laparoscopy as a cystic tumor in the mesosalpinx distant from the fallopian tube and ovary. Pathology showed a cyst inner surface lined with cuboidal epithelium with hemosiderin deposition, and the diagnosis was supported by immunohistology positive for CD10 and vimentin, as well as estrogen and progesterone receptors indicating Müllerian-type epithelial character, with variable calretinin positivity. The authors interpret a calretinin-negative transition as potentially reflecting metaplasia from peritoneal mesothelium to Müllerian-type epithelium, aligning with the coelomic metaplasia theory, and they note that laparoscopic macroscopic findings helped reach the conclusion. This paper is centrally about endometriosis — specifically an endometriotic cyst in the mesosalpinx and its proposed pathogenesis via coelomic metaplasia.

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Abstract

Endometriotic cysts often develop in the ovaries, while endometriotic nodules commonly develop in extra-ovarian sites. Herein, we report a rare case of an endometriotic cyst occurring in the mesosalpinx, and immunohistological reviews of it's the pathogenesis. Magnetic resonance imaging of a 36-year-old multiparous female patient detected a 6 cm-large cyst in the right adnexal region. Likewise, a cystic tumor in the right mesosalpinx distant to the right fallopian tube and ovary, was detected via laparoscopy. On pathological examination, the inner surface of the cyst was lined with cuboidal epithelium and showed hemosiderin deposition and, thus, was diagnosed as an endometriotic cyst. Immunohistologically, it was positive for CD10 and vimentin, further supporting the diagnosis of endometriotic cyst. It was also positive for estrogen and progesterone receptors, indicative of a Müllerian-type epithelial character, and parts with positivity and negativity for the mesothelial marker calretinin were found. The calretinin-negative transition was considered to be due to a metaplastic process from peritoneal mesothelium to Müllerian-type epithelium. In conclusion, the coelomic metaplasia theory is possibly involved in the pathogenesis of endometriotic cysts located in the mesosalpinx. Detailed macroscopic findings via laparoscopy were also helpful in reaching this conclusion.
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症例報告 卵管間膜内に発生した子宮内膜症性嚢胞の一例―子宮内膜症の発生機序についての検討を加えて― 2021 年 37 巻 1 号 p. 176-183 詳細 抄録 Endometriotic cysts often develop in the ovaries, while endometriotic nodules commonly develop in extra-ovarian sites. Herein, we report a rare case of an endometriotic cyst occurring in the mesosalpinx, and immunohistological reviews of it's the pathogenesis. Magnetic resonance imaging of a 36-year-old multiparous female patient detected a 6 cm-large cyst in the right adnexal region. Likewise, a cystic tumor in the right mesosalpinx distant to the right fallopian tube and ovary, was detected via laparoscopy. On pathological examination, the inner surface of the cyst was lined with cuboidal epithelium and showed hemosiderin deposition and, thus, was diagnosed as an endometriotic cyst. Immunohistologically, it was positive for CD10 and vimentin, further supporting the diagnosis of endometriotic cyst. It was also positive for estrogen and progesterone receptors, indicative of a Müllerian-type epithelial character, and parts with positivity and negativity for the mesothelial marker calretinin were found. The calretinin-negative transition was considered to be due to a metaplastic process from peritoneal mesothelium to Müllerian-type epithelium. In conclusion, the coelomic metaplasia theory is possibly involved in the pathogenesis of endometriotic cysts located in the mesosalpinx. Detailed macroscopic findings via laparoscopy were also helpful in reaching this conclusion. © 2021 日本産科婦人科内視鏡学会

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