Selected Case From the Arkadi M. Rywlin International Pathology Slide Club

Dimuth N Gunawardane, Philip W Allen
Advances in anatomic pathology · 2015 · vol. 22(5) , pp. 331–334 · doi:10.1097/pap.0000000000000081 · PMID:26262516 · W2418311900
article OA: closed CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case describes a polypoid endometriosis with decidual reaction and necrosis diagnosed in a patient receiving progestogen, initially interpreted as recurrent endometriosis or adenosarcoma.

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Abstract

A 50-year-old female had a hysterectomy and bilateral salpingo-oophorectomy for adenomyosis, uterine leiomyomas, ovarian and cervical endometriosis. Nine months later, organ imaging revealed a 43×74×52 mm, apparently malignant extraperitoneal mass lying between the vagina and rectum. The patient had been receiving a progestogen. Preoperative needle biopsies were interpreted as recurrent endometriosis. The mass was easily excised and sections were interpreted as polypoid endometriosis with a decidual reaction and foci of necrosis. Slides circulated to the club were from the excised specimen. The majority agreed with this diagnosis although a minority favored a Mullerian adenosarcoma. One club member commented that pseudosarcomatous change, including periglandular stromal cuffing and condensation, may occur in patients on hormones, especially tamoxifen. The patient was well with no recurrence 15 months after surgery.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Douglas' Pouch Endometriosis Perimenopause Peritoneal Diseases Biopsy, Needle Diagnosis, Differential Douglas' Pouch Douglas' Pouch Endometriosis Endometriosis Female Humans Middle Aged Peritoneal Diseases Peritoneal Diseases Predictive Value of Tests

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (11)

Cited by (3)

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