Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Gynaecol Obstet. 2023 Oct;163(1):44-50. doi: 10.1002/ijgo.14764. Epub 2023 Apr 4.
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.
子宫内膜化生的特征是存在异位的、良性的具有输卵管样纤毛上皮的腺体。富细胞性子宫内膜化生（FCE）是一种罕见的子宫内膜化生类型，表现为肿瘤样病变。一般来说，FCE 没有特定的临床特征。在本例中，患者在第二次剖宫产时首先观察到并切除了广泛的盆腔多发性 Müller 氏囊肿。一年后病变复发。因此，患者接受了全子宫切除术和双侧输卵管切除术；病理结果显示患者患有 FCE。根据随访期间的影像学研究，观察到复发性和进行性的盆腔和盆腔外多发性囊肿。患者无明显症状，实验室检查结果正常。进行了超声引导下抽吸和曲安奈德硬化治疗，在过去的一年中，囊肿稳定，没有进展。这是首例全子宫切除术和双侧输卵管切除术 5 年后复发 FCE 的报道病例。本文还对该病例进行了文献复习，并提出了基于该病例的 FCE 诊断和治疗的新观点。
