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Case Report
Polypoid endometriosis: A rare variant and a mimic of ovarian malignancy
1 Gynecologic Oncology, Senior Consultant, Gynecologic Oncology, Department of Surgical Oncology, BLK Cancer Centre, BLK-Max Super Speciality Hospital, Delhi, India
2 Obstetrics & Gynecology, MNAMS, Fellowship in Gynecologic Oncology, Associate Consultant, Gynecologic Oncology, Department of Surgical Oncology, BLK Cancer Centre, BLK-Max Super Speciality Hospital, Delhi, India
3 Pathology, Consultant, Histopathology & Cytopathology, BLK-Max Super Speciality Hospital, Delhi, India
4 Pathology, Associate Director & HOD, Histopathology & Cytopathology, BLK-Max Super Speciality Hospital, Delhi, India
5 Senior Consultant, Radiology, Department of Radiology, BLK-Max Super Speciality Hospital, Delhi, India
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Neha Kumar
Senior Consultant, Gynecologic Oncology, Department of Surgical Oncology, BLK Cancer Centre, BLK-Max Super Speciality Hospital, Delhi,
India
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Article ID: 101302Z01NK2022
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Kumar N, Nayyar N, Garg D, Duggal R, Khadaria N. Polypoid endometriosis: A rare variant and a mimic of ovarian malignancy. Int J Case Rep Images 2022;13:101302Z01NK2022.ABSTRACT
Introduction: Polypoid endometriosis is a rare form of endometriosis, distinct from classical or usual endometriosis. Unlike usual endometriosis which usually presents in young women, polypoid endometriosis occurs more commonly in postmenopausal women. It mimics malignancy and simulates ovarian cancer, not only on preoperative investigations but also intraoperatively, causing a diagnostic dilemma.
Case Report: We describe here, a case of polypoid endometriosis that was presumed to be a case of ovarian cancer with peritoneal dissemination preoperatively. Contrast enhanced computed tomography (CT) scan revealed bilateral solid-cystic adnexal lesions, moderate ascites, and peritoneal thickening. Serum CA-125 was 1057 U/mL and serum HE4 was 88 pmol/L. Due to high index of suspicion of malignancy, the patient was taken for exploratory laparotomy and underwent hysterectomy with bilateral adnexectomy with excision of deposits over pouch of Douglas and both ureters and excision of adherent thickened omentum. Intraoperative frozen section as well as the final histopathology was reported as polypoid endometriosis.
Conclusion: It is imperative for the gynecologist, oncologist, and pathologist to know of this rare benign entity and distinguish it from ovarian malignancy, in order to avoid radical surgery and overtreatment. Surgery with complete removal of all lesions is the cornerstone of management of polypoid endometriosis and the patients generally have a good prognosis.
Keywords: Cancer mimic, Endometriosis, Ovarian cancer, Polypoid endometriosis
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Author Contributions
Neha Kumar - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nidhi Nayyar - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Deepasha Garg - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rajan Duggal - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Narottam Khadaria - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Neha Kumar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
