Tumor Mimicking Bladder Endometriosis

In: Medical Science and Discovery · 2015 · vol. 2(1) , pp. 161–164 · doi:10.36472/msd.v2i1.65 · W4407293178
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This paper describes three cases of bladder endometriosis, characterized by solid or polypoid masses on the bladder wall in patients with a history of cesarean section, and highlights its presence in the differential diagnosis of urinary tract lesions.

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The paper reports three hospital cases of patients presenting with dysuria and abdominal pain who had prior cesarean sections, with radiology showing solid bladder wall masses (one also with a polypoid intraluminal lesion). Transurethral resection was performed in two cases and partial cystectomy in one, and histology showed endometrial stroma and glands within smooth muscle, with stromal CD10 positivity and epithelial estrogen and progesterone receptor positivity. The authors emphasize that such bladder lesions can mimic tumor-forming urinary tract pathology, so bladder endometriosis should be included in the differential diagnosis. This paper is centrally about endometriosis — it focuses on bladder endometriosis that presents as tumor-like urinary tract lesions.

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Abstract

Endometriosis is described as the presence of endometrial tissue outside the uterine corpus. Though urinary tract endometriosis is uncommon, the bladder is the most common localization amongst them. Here we present three cases admitted to our hospital with similar complaints such as dysuria and abdominal pain. All of the patients had previous cesarean section history. And radiological examination of the bladder revealed solid masses located on the bladder wall. One of the case additionally had a protruding, polipoid luminal mass. Two of the cases were treated with transurethral resection and one with partial cystectomy. We noted similar histological findings such as endometrial stroma and glands within the smooth muscle fibers. The stromal components were positive with CD10, epithelial components were positive with both estrogen and progesterone receptor immunohistochemically. As a result bladder endometriosis should be kept in mind in the differential diagnosis of mass forming urinary tract lesions.
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Abstract

Endometriosis is described as the presence of endometrial tissue outside the uterine corpus. Though urinary tract endometriosis is uncommon, the bladder is the most common localization amongst them. Here we present three cases admitted to our hospital with similar complaints such as dysuria and abdominal pain. All of the patients had previous cesarean section history. And radiological examination of the bladder revealed solid masses located on the bladder wall. One of the case additionally had a protruding, polipoid luminal mass. Two of the cases were treated with transurethral resection and one with partial cystectomy. We noted similar histological findings such as endometrial stroma and glands within the smooth muscle fibers. The stromal components were positive with CD10, epithelial components were positive with both estrogen and progesterone receptor immunohistochemically. As a result bladder endometriosis should be kept in mind in the differential diagnosis of mass forming urinary tract lesions. Downloads Article Details This journal uses the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license, users are free to: - Share — copy and redistribute the material in any medium or format - Adapt — remix, transform, and build upon the material for any purpose, even commercially Under the following terms: - Attribution — appropriate credit must be given, a link to the license must be provided, and changes (if any) must be indicated. License URL: https://creativecommons.org/licenses/by/4.0/ - Abstract 503 - Full Text (PDF) 460

References

Bologna RA, Whitmore KE. Genitourinary endometriosis. AUA Update Series. 2001;1:21. Perez-Utrilla Perez M, Aguilera Bazan A, Alonso Dorrego JM, Hernandez A, de Francisco MG, Martin Hernandez M, et al. Urinary tract endometriosis: clinical, diagnostic, and therapeutic aspects. Urology. 2009;73(1):47-51. Gabriel B, Nassif J, Trompoukis P, Barata S, Wattiez A. Prevalence and management of urinary tract endometriosis: a clinical case series. Urology. 2011;78(6):1269-74. Donnez J, Spada F, Squifflet J, Nisolle M. Bladder endometriosis must be considered as bladder adenomyosis. Fertility and sterility. 2000;74(6):1175-81. Epstein JI, Reuter VE, Amin MB. Biopsy Interpretation of Bladder. 2nd ed. Philedelphia, Lippincott Williams &Wilkins. 2010;180-213. Siva AB, Srivastava P, Shivaji S. Understanding the pathogenesis of endometriosis through proteomics: recent advances and future prospects. Proteomics Clinical applications. 2014;8(1-2):86-98. Al-Khawaja M, Tan PH, MacLennan GT, Lopez-Beltran A, Montironi R, Cheng L. Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases. Human pathology. 2008;39(6):954-9. Andolf E, Thorsell M, Kallen K. Caesarean section and risk for endometriosis: a prospective cohort study of Swedish registries. BJOG : an international journal of obstetrics and gynaecology. 2013;120(9):1061-5. Seracchioli R, Mabrouk M, Montanari G, Manuzzi L, Concetti S, Venturoli S. Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up. Fertility and sterility. 2010;94(3):856-61. Antonelli A, Simeone C, Zani D, Sacconi T, Minini G, Canossi E, et al. Clinical aspects and surgical treatment of urinary tract endometriosis: our experience with 31 cases. European urology. 2006;49(6):1093-7; discussion 7-8.

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endometriosisbladder_endometriosis

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