Magnetic resonance imaging findings of endosalpingiosis: a case report

Refractory florid cystic endosalpingiosis: A case report with 5 years follow up and literature review

Endosalpingiosis is characterized by the presence of ectopic, benign glands with a fallopian tube-like ciliated epithelium. Florid cystic endosalpingiosis (FCE) is a rare type of endosalpingiosis and presents with tumor-like lesions. In general, FCE has no specific clinical features. In this case, extensive pelvic multiple Müllerian cysts were first observed and removed during the patient's second cesarean section. Lesions relapsed after a year. Therefore, the patient underwent total hysterectomy and bilateral salpingectomy; pathology revealed that the patient had FCE. According to imaging studies during the follow up, recurrent and progressive multiple pelvic and extra-pelvic cysts were observed. The patient had no obvious symptoms, and the results of her laboratory tests were within normal limits. Ultrasound-guided aspiration and lauromacrogol sclerotherapy were performed, and in the past year, the cysts have stabilized without progression. This is the first reported case of recurrent FCE after total hysterectomy and bilateral salpingectomy with a 5-year follow up. A literature review and novel ideas for diagnosing and managing FCE based on this case are also presented.

Intraoperative Appearance of Endosalpingiosis: A Single-Center Experience of Laparoscopic Findings and Systematic Review of Literature

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.

Diffuse abdominal and pelvic endosalpingiosis: A case report

Endosalpingiosis is defined as the ectopic location of benign ciliated tubal epithelium outside of the fallopian tubes. It is a rare entity that was previously regarded as an incidental finding on pathology, and is becoming more prevalent within the medical literature. Diagnosis is made based on histologic sampling. There are no specific radiological features but commonly reported findings include numerous cystic and solid masses scattered throughout the pelvis. Common ectopic locations seen on imaging include the serosa of the uterus, fallopian tubes, ovaries and the pelvic cul-de-sac. Less common locations include the bladder wall, omentum, bowel serosa, and skin. We present the clinical presentation of a patient with histologically proven endosalpingiosis. Atypical imaging findings and correlative histology are also reviewed.