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Intraoperative Appearance of Endosalpingiosis: A Single-Center Experience of Laparoscopic Findings and Systematic Review of Literature. J Clin Med 2022; 11:jcm11237006. [PMID: 36498581 PMCID: PMC9738105 DOI: 10.3390/jcm11237006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a significant association with gynecologic malignancies, many underlying principles remain unclear. This work aimed to systematically describe the intraoperative appearance of endosalpingiosis. Methods: Data and intraoperative videos of patients with histologically verified endosalpingiosis were retrospectively reviewed. The main outcome measures were macroscopic phenotype and anatomical distribution. Additionally, a systematic review searching PubMed (Medline) and Embase was conducted. Results: In the study population (n = 77, mean age 40.2 years (SD 16.4)), the mean size of lesions was 3.6 mm and the main visual pattern was vesicular (62%). The most frequent localization was the sacrouterine ligaments (24.7%). In the systematic review population (n = 1174 (210 included studies overall), mean age 45.7 years (SD 14.4)), there were 99 patients in 90 different studies with adequate data to assess the appearance of the lesions. The mean size of the lesions was 48.5 mm, mainly with a cystic visual pattern (49.5%). The majority of the lesions affected the ovaries (23.2%), fallopian tubes (20.4%), or lymph nodes (18.5%). Comparing this study to the literature population, the main differences concerned the size (p < 0.001) and main visual patterns (p < 0.001) of lesions. Conclusions: The usual intraoperative findings of endosalpingiosis appeared less impressive than described in the literature. In our study population, lesions of a few millimeters in size with a vesicular appearance were mostly seen, most frequently in the sacrouterine ligament area. Intraoperative recognition by the gynecologic surgeon and histologic diagnosis should play an important role in further understanding this entity, scientifically and clinically.
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Ghosh S, Onol F, Vasquez J, Parikh J. Müllerianosis of the Urinary Bladder: A Rare Condition Which Mimics Neoplasia. Cureus 2021; 13:e15147. [PMID: 34178484 PMCID: PMC8216577 DOI: 10.7759/cureus.15147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/05/2022] Open
Abstract
Müllerianosis of the urinary bladder is an extremely rare, benign condition defined by the presence of at least two of the three müllerian-derived components (endosalpinx, endometrium, and endocervix) in the lamina propria and muscularis propria of the urinary bladder. It frequently mimics neoplastic condition, either malignant or benign. Here, we present a case of cystic müllerianosis of urinary bladder, which was clinically thought to be a urinary bladder neoplasm.
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Affiliation(s)
- Somshukla Ghosh
- Internal Medicine, University of Central Florida-HCA Healthcare Graduate Medical Education, Greater Orlando, USA
| | - Fikret Onol
- Urology, Orlando Veterans Affairs Medical Center, Orlando, USA
| | - Jonathan Vasquez
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
| | - Jignesh Parikh
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
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Maheshwari S, Bhat V, Gadabanahalli K, Raju N, Kulkarni P. Endosalpingiosis of urinary bladder: report on a rare entity. BJR Case Rep 2020; 6:20190129. [PMID: 32922838 PMCID: PMC7465734 DOI: 10.1259/bjrcr.20190129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/01/2020] [Indexed: 11/16/2022] Open
Abstract
A case of endosalpingiosis of the urinary bladder is presented with imaging features on sonography and CT. Patient presented with right flank pain, dysuria and haematuria. She had h/o right renal calculus and abdominal hysterectomy 15 years ago. On sonography a polypoidal filling defect was noted and possibility of a bladder neoplasia was suggested. On cystoscopy and removal of the lesion and subsequent histo-pathological analysis revealed the diagnosis of endosalphingiosis. This report emphasizes the need for evaluation of all clinical inputs while considering the differential diagnosis of an intraluminal bladder lesion. Imaging appearance and aetio-pathology of the rare intra vesical lesion is highlighted.
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Affiliation(s)
| | | | | | - Nalini Raju
- Department of Pathology, Narayana Health, Bengaluru, Karnataka, India
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Habiba M, Brosens I, Benagiano G. Müllerianosis, Endocervicosis, and Endosalpingiosis of the Urinary Tract: A Literature Review. Reprod Sci 2018; 25:1607-1618. [PMID: 29739266 DOI: 10.1177/1933719118773441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We reviewed reported cases of endocervicosis, endosalpingiosis, and müllerianosis of the bladder or ureters in women in order to highlight these conditions as distinct from endometriosis or adenomyosis. METHODS Medline and Scopus searches of all cases published till the October 1, 2017. All retrieved references were searched manually to identify relevant articles. RESULTS Twenty-six articles reported endocervicosis. These included 37 cases described by the authors as endocervicosis of the bladder. We identified 7 case reports of bladder endosalpingiosis. There were 26 publications including 27 cases of müllerianosis of the bladder and 3 cases affecting the lower ureter. Literature descriptions are limited but available accounts do not point to features that uniquely distinguished these conditions. Affected women tended to be older, and in many cases, there was a possible relation to past surgery and particularly to hysterectomy and caesarean sections. Many cases were reported in postmenopausal women. Local excision was sufficient in most cases. CONCLUSION The etiology of these conditions remains speculative, but case reports raise a possible link to pelvic surgery. There is a need for more detailed accounts of these lesions, which should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain or discomfort, dysuria, frequency, or hematuria.
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Affiliation(s)
- Marwan Habiba
- 1 Department of Health Sciences, University of Leicester, Women and Perinatal Services, University Hospitals of Leicester, Leicester, United Kingdom
| | - Ivo Brosens
- 2 Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Giuseppe Benagiano
- 3 Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy
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Vaginal Endosalpingiosis Case Report: A Rare Entity Presenting as Intermenstrual Bleeding. Case Rep Obstet Gynecol 2017; 2017:2424392. [PMID: 29250450 PMCID: PMC5700479 DOI: 10.1155/2017/2424392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/18/2017] [Indexed: 12/02/2022] Open
Abstract
Endosalpingiosis is a benign and rare entity whose pathophysiology remains unknown. It has been described in pelvic organs, the abdomen, or axillar lymph nodes. Its underrecognition has occasionally led to its misinterpretation for an adenocarcinoma. This case reports the treatment and follow-up of vaginal endosalpingiosis, presenting as a vaginal polyp in a premenopausal women with intermenstrual bleeding. To our knowledge this is the first reported case of vaginal endosalpingiosis and the second mucosal localization after bladder endosalpingiosis.
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Zapardiel I, Tobias-Gonzalez P, de Santiago J. Endosalpingiosis mimicking recurrent ovarian carcinoma. Taiwan J Obstet Gynecol 2013; 51:660-2. [PMID: 23276578 DOI: 10.1016/j.tjog.2012.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2012] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ignacio Zapardiel
- Gynaecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.
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Guan H, Rosenthal DL, Erozan YS. Mullerianosis of the urinary bladder: report of a case with diagnosis suggested in urine cytology and review of literature. Diagn Cytopathol 2011; 40:997-1001. [PMID: 21538955 DOI: 10.1002/dc.21693] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 02/16/2011] [Indexed: 11/06/2022]
Abstract
Mullerianosis of the urinary bladder is a rare entity characterized by the presence of an admixture of at least two types of mullerian tissue in the muscularis propria of the bladder. We report a case of mullerianosis of the urinary bladder in a 28-year-old nulliparous woman with no history of pelvic surgery or endometriosis, and the diagnosis of mullerianosis was suggested initially in urine cytopathology report. In this study, previously reported cases of mullerianosis of urinary bladder are reviewed, and differential diagnosis of endometrial-like cells in the urine has been discussed. Fewer than 20 cases of mullerianosis of the urinary bladder have been reported in the literature, and only one of these cases had cytological description in a urine specimen. Most of patients were of reproductive age ranging from 28 to 53 years and had no previous history of pelvic surgery or Cesarean section. The clinical presentations frequently were abdominal/pelvic pain and dysuria/hematuria, which may or may not be associated with menstruation. Radiologic study revealed polypoid, mass-like lesion ranging from 1 to 4.5 cm in size, predominantly involving the dome or posterior wall of the bladder. Histological sections showed two or more of the three related benign mullerian glandular epithelial proliferations-endometriosis, endosalpingiosis, and endocervicosis. Most of the patients have good prognosis with medical management.
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Affiliation(s)
- Hui Guan
- Department of Pathology, Division of Cytopathology, The Johns Hopkins Medical Institute, Baltimore, Maryland 21287-8048, USA.
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Papavramidis TS, Sapalidis K, Michalopoulos N, Karayannopoulou G, Cheva A, Papavramidis ST. Umbilical endosalpingiosis: a case report. J Med Case Rep 2010; 4:287. [PMID: 20735830 PMCID: PMC2936926 DOI: 10.1186/1752-1947-4-287] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 08/24/2010] [Indexed: 12/19/2022] Open
Abstract
Introduction Endosalpingiosis describes the ectopic growth of Fallopian tube epithelium. Pathology confirms the presence of a tube-like epithelium containing three types of cells: ciliated, columnar cells; non-ciliated, columnar secretory mucous cells; and intercalary cells. We report the case of a woman with umbilical endosalpingiosis and examine the nature and characteristics of cutaneous endosalpingiosis by reviewing and combining the other four cases existing in the international literature. Case presentation A 50-year-old Caucasian, Greek woman presented with a pale brown nodule in her umbilicus. The nodule was asymptomatic, with no cyclical discomfort or variation in size. Her personal medical, surgical and gynecologic history was uneventful. An excision within healthy margins was performed under local anesthesia. A cystic formation measuring 2.7×1.7×1 cm was removed. Histological examination confirmed umbilical endosalpingiosis. Conclusions Umbilical endosalpingiosis is a very rare manifestation of the non-neoplasmatic disorders of the Müllerian system. It appears with cyclic symptoms of pain and swelling of the umbilicus, but not always. The disease is diagnosed using pathologic findings and surgical excision is the definitive treatment.
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Affiliation(s)
- Theodossis S Papavramidis
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Maniar KP, Kalir TL, Palese MA, Unger PD. Endosalpingiosis of the urinary bladder: a case of probable implantative origin with characterization of benign Fallopian tube immunohistochemistry. Int J Surg Pathol 2009; 18:381-3. [PMID: 19282293 DOI: 10.1177/1066896909332730] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Müllerianosis of the bladder is an infrequently described lesion consisting of multiple Müllerian-type tissues within the urinary bladder. Few previous cases of pure endosalpingiosis have been described. Here we present a 54-year-old post-menopausal female with a history of prior pelvic surgery with traumatic bladder injury, who was found to have a cystic lesion in the posterior wall of the bladder. Routine histology demonstrated cyst epithelium characteristic of endosalpingiosis. Three benign Fallopian tube specimens were obtained and stained with the relevant immunohistochemical markers for comparison. Results showed an identical immunohistochemical profile between the bladder cyst lining and the normal Fallopian tube controls. This case represents a rare instance of pure endosalpingiosis of the urinary bladder, with a likely implantative origin. This form of bladder Müllerianosis should therefore be considered within the differential diagnosis of cystic lesions of the bladder.
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Affiliation(s)
- Kruti P Maniar
- Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, USA.
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Endosalpingiosis of choledochal duct. Surgery 2007; 142:778. [PMID: 17981201 DOI: 10.1016/j.surg.2007.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 06/27/2007] [Indexed: 11/23/2022]
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Smith C, Sabet L, Izawa JI. Management of endosalpingiosis of urinary bladder. Urology 2005; 64:1031. [PMID: 15533512 DOI: 10.1016/j.urology.2004.05.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2004] [Accepted: 05/27/2004] [Indexed: 11/24/2022]
Abstract
We report on a 48-year-old woman who presented with abnormal uterine bleeding secondary to uterine fibroids and who was found to have incidental endosalpingiosis of the urinary bladder. Follow-up is necessary for bladder endosalpingiosis because of its tendency to recur. Follow-up should include cystoscopy and renal, and possibly pelvic, ultrasonography.
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Affiliation(s)
- Cortney Smith
- Department of Surgery, The University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada
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Carrick KS, Milvenan JS, Albores-Saavedra J. Serous tumor of low malignant potential arising in inguinal endosalpingiosis: report of a case. Int J Gynecol Pathol 2004; 22:412-5. [PMID: 14501827 DOI: 10.1097/01.pgp.0000092155.33490.52] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 46-year-old woman presented with a right inguinal mass. Imaging studies revealed no abnormalities of the pelvis (including the ovaries) or abdomen. The inguinal mass was composed predominantly of variably sized cysts lined by flat to low cuboidal cells resembling mesothelial cells and ciliated columnar tubal-type cells with a focal transition between the two cell types. Papillae, detached cell clusters with mild cytologic atypia, and psammoma bodies were also found, warranting a diagnosis of a serous borderline tumor. This appears to be the first report of a serous borderline tumor arising in inguinal endosalpingiosis and not associated with an ovarian serous tumor.
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Affiliation(s)
- Kelley S Carrick
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA.
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Ong NCS, Maher PJ, Pyman JM, Readman E, Gordon S. Endosalpingiosis, an unrecognized condition: report and literature review. ACTA ACUST UNITED AC 2004. [DOI: 10.1007/s10397-003-0001-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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