Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature

INTRODUCTION: Endosalpingiosis is a disorder of Mullerian system characterized by benign glands lined by tubal type epithelium and involves the peritoneum, subperitoneal tissues, and retroperitoneal lymph nodes. Endosalpingiosis is almost an incidental finding on microscopic examination. Seldom it appears as a cyst and it can be confused clinically for an ovarian tumor. DESIGN: A case report and a systematic review about pelvic mass-like florid endosalpingiosis of the uterus from PUB MED database were performed. PATIENT(S): We describe a case report of a 50-year-old woman with a pedunculated uterine neoformation, for which the preoperative exams could be compatible with an adnexal mass. Twelve patients with similar clinical history were discussed in the review. TREATMENT: Laparoscopy with radical exeresis was performed. RESULTS: Microscopic exam revealed florid cystic endosalpingiosis of the uterus. CONCLUSIONS: Endosalpingiosis is a rare mullerian disorder and the main problem is that the symptomatology is not specific and it may be initially misinterpreted. In relation to the papillary aspect of the lesion and focal calcifications, the histological differential diagnosis could include serous adenocarcinoma, but the lack of cellular stratification in absence of mitotic activity, and the presence of slight nuclear atypia contradict the diagnosis of carcinoma. The differential diagnosis for endosalpingiosis also includes multiple peritoneal inclusion cysts (benign cystic mesothelioma). The aim of this case report has not been only to describe the rarity of this pathology, but it contributes to consider endosalpingiosis as a possible diagnostic hypothesis for which may be indicated a conservative surgical treatment.