Polypoid endometriosis of the ovary and müllerianosis of pelvic lymph nodes mimicking an ovarian carcinoma with lymph node metastasis

Iida Y, Yasushi Iida, Tabata J, Junya Tabata, Takashi Yorozu, Yorozu T, Kitai S, Satomi Kitai, Kazu Ueda, Ueda K, Saito M, Motoaki Saito, Yanaihara N, Nozomu Yanaihara, Yamada K, Kyosuke Yamada, Aikou Okamoto, Okamoto A
International cancer conference journal · 2017 · vol. 6(4) , pp. 145–148 · doi:10.1007/s13691-017-0295-9 · PMID:31149490 · PMC6498387 · W2606226635
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-11 ⓘ

This report describes a rare case of ovarian polypoid endometriosis and pelvic lymph node müllerianosis that radiographically mimicked ovarian carcinoma with metastasis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports a rare 44-year-old case in which magnetic resonance imaging showed an ovarian mass with papillary nodules up to 3.0 cm and enlarged pelvic lymph nodes, raising concern for ovarian carcinoma with lymph node metastasis. The authors considered polypoid endometriosis in the differential diagnosis based on MRI and included it in the intraoperative consultation, but carcinoma could not be excluded. Histological examination ultimately diagnosed polypoid endometriosis of the left ovary with glandular hyperplasia and müllerianosis in the obturator pelvic lymph nodes, and they note it as the first reported case of this combination in pelvic lymph nodes. This paper is centrally about endometriosis — it describes polypoid endometriosis of the ovary and related lymph-node müllerianosis that mimicked ovarian carcinoma, with no specific adenomyosis focus.

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Abstract

Polypoid endometriosis is a distinctive variant of endometriosis with histological features simulating those of endometrial polyps. Müllerianosis is characterized by the presence of lesions at any site containing admixtures of endosalpingiosis, endometriosis, and endocervicosis. Here, we report a rare case of polypoid endometriosis of the ovary with müllerianosis of the pelvic lymph nodes in a 44-year-old woman without a past history of pelvic surgery. Magnetic resonance imaging revealed an ovarian tumor containing papillary nodules up to 3.0 cm in diameter and left pelvic lymph node enlargement. Nodules in ovarian tumor showed heterogeneous high intensity on T2-weighted image and high intensity on diffusion-weighted image and were mildly enhanced by gadolinium contrast material. Enlarged lymph node was markedly enhanced by gadolinium. We considered polypoid endometriosis in the differential diagnosis according to the results of the magnetic resonance imaging, and polypoid endometriosis was included in intraoperative consultation, however, ovarian carcinoma with lymph node metastasis could not be denied. According to histological examination, the final diagnosis was determined as polypoid endometriosis with glandular hyperplasia of the left ovary and müllerianosis in the obturator lymph nodes. To the best of our knowledge, this is the first report of polypoid endometriosis and müllerianosis of the pelvic lymph node.
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Abstract

Polypoid endometriosis is a distinctive variant of endometriosis with histological features simulating those of endometrial polyps. Müllerianosis is characterized by the presence of lesions at any site containing admixtures of endosalpingiosis, endometriosis, and endocervicosis. Here, we report a rare case of polypoid endometriosis of the ovary with müllerianosis of the pelvic lymph nodes in a 44-year-old woman without a past history of pelvic surgery. Magnetic resonance imaging revealed an ovarian tumor containing papillary nodules up to 3.0 cm in diameter and left pelvic lymph node enlargement. Nodules in ovarian tumor showed heterogeneous high intensity on T2-weighted image and high intensity on diffusion-weighted image and were mildly enhanced by gadolinium contrast material. Enlarged lymph node was markedly enhanced by gadolinium. We considered polypoid endometriosis in the differential diagnosis according to the results of the magnetic resonance imaging, and polypoid endometriosis was included in intraoperative consultation, however, ovarian carcinoma with lymph node metastasis could not be denied. According to histological examination, the final diagnosis was determined as polypoid endometriosis with glandular hyperplasia of the left ovary and müllerianosis in the obturator lymph nodes. To the best of our knowledge, this is the first report of polypoid endometriosis and müllerianosis of the pelvic lymph node. Similar content being viewed by others

References

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