Selected Case From the Arkadi M. Rywlin International Pathology Slide Club: Polypoid Endometriosis in the Pouch of Douglas in a Perimenopausal Woman

Dimuth N. Gunawardane, Gunawardane DN, Allen PW, Philip W. Allen
Advances in anatomic pathology · 2015 · vol. 22(5) , pp. 331–334 · doi:10.1097/pap.0000000000000081 · PMID:26262516 · W2418311900
Case report OA: closed CC0 ⤵ 3 in-corpus citations
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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 Perimenopause Peritoneal Diseases Biopsy, Needle Biopsy, Needle Diagnosis, Differential Diagnosis, Differential Douglas' Pouch Douglas' Pouch Douglas' Pouch Endometriosis Endometriosis Endometriosis Female Female Humans Humans Middle Aged

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (11)

Cited by (3)

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