Fan Yu-Min, Wang Tao-Yeuan, Chen Jen-Ruei
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Pathology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
Taiwan J Obstet Gynecol. 2025 Jan;64(1):166-169. doi: 10.1016/j.tjog.2024.04.022.
Polypoid endometriosis is a rare mass-like variant of endometriosis. Mass-like content with indistinct margins between the uterus and pelvic side wall mimics characteristics of pelvic malignancy. Systemic lupus erythematosus (SLE) has also been associated with higher incidences of endometriosis. However, SLE cases with polypoid endometriosis have never been reported in English literature.
A 33-year-old female presented with SLE and polypoid endometriosis. Initially, she received a left salpingo-oophorectomy due to suspicion of ovarian malignancy, but only endometrioma with polypoid feature was diagnosed. Repeated second surgery was conducted because of a new-growth complex mass between the uterus and the pelvic side wall, causing myometrial invasion and left hydroureter/hydronephrosis. Finally, polypoid endometriosis of the pelvic side wall was diagnosed pathologically.
Polypoid endometriosis is still a diagnostic challenge before pathological confirmation. This case of SLE and polypoid endometriosis may be the first reported worldwide.
息肉样子宫内膜异位症是一种罕见的、类似肿块的子宫内膜异位症变体。子宫与盆腔侧壁之间边缘不清的肿块样内容物类似于盆腔恶性肿瘤的特征。系统性红斑狼疮(SLE)也与子宫内膜异位症的较高发病率有关。然而,英文文献中从未报道过伴有息肉样子宫内膜异位症的SLE病例。
一名33岁女性患有SLE和息肉样子宫内膜异位症。最初,由于怀疑卵巢恶性肿瘤,她接受了左侧输卵管卵巢切除术,但仅诊断出具有息肉样特征的子宫内膜瘤。由于子宫与盆腔侧壁之间出现新生长的复杂肿块,导致子宫肌层浸润和左侧输尿管积水/肾盂积水,因此进行了重复的二次手术。最后,经病理诊断为盆腔侧壁息肉样子宫内膜异位症。
在病理确诊之前,息肉样子宫内膜异位症仍是一个诊断难题。这例SLE合并息肉样子宫内膜异位症可能是全球首例报道。