Wu Zaigui, Xu Qiong, Sun Yao, Ruan Fei
Department of General Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, People's Republic of China.
Int J Womens Health. 2025 Apr 13;17:1049-1054. doi: 10.2147/IJWH.S508521. eCollection 2025.
Polypoid endometriosis is rare and differs from classic endometriosis. It has been primarily documented in case reports and often misdiagnosed as malignancy. The aim of this study is to report three separate cases of polypoid endometriosis coincided with multiple abscess, angioleiomyoma or stromal sarcoma, respectively.
The first case was 36 years old and presented with six months of dysmenorrhea and menstrual fever. Two cervical masses, one located in vaginal and one in pelvic, were detected by ultrasound. After a total hysterectomy, she was diagnosed with cervical polypoid endometriosis with multiple abscess. The second case aged 36-years too and had menstrual bleeding prolonged to 10-15 days for four months. Ultrasound showed a 6cm mass like leiomyomas but with rich vascularity, while MRI tested signal intensity similar to that of endometrium. A diagnosis of polypoid endometriosis coincided with angioleiomyoma was made after surgery. The third patient was 40 and experienced lower abdominal pain for eight months. The ultrasound and MRI tested multiple solid-cystic masses in the left ovary and pelvic. The subsequent pathology revealed extensive stromal nodules in various areas such as bilateral ovaries, posterior uterine wall, intestinal tract and left ureter, indicating the diagnosis of low malignant potential stromal sarcoma.
Polypoid endometriosis coincided with multiple abscess, angioleiomyoma or stromal sarcoma are rather rare and require aggressive surgical treatment.
息肉样子宫内膜异位症较为罕见，与经典的子宫内膜异位症不同。其主要在病例报告中有所记载，且常被误诊为恶性肿瘤。本研究的目的是报告三例分别合并多发性脓肿、血管平滑肌瘤或间质肉瘤的息肉样子宫内膜异位症病例。
第一例患者36岁，有六个月的痛经和经期发热症状。超声检查发现两个宫颈肿物，一个位于阴道，一个位于盆腔。全子宫切除术后，她被诊断为宫颈息肉样子宫内膜异位症合并多发性脓肿。第二例患者也是36岁，四个月来月经出血延长至10 - 15天。超声显示一个6厘米大小类似平滑肌瘤但血管丰富的肿物，而磁共振成像检查其信号强度与子宫内膜相似。手术后诊断为息肉样子宫内膜异位症合并血管平滑肌瘤。第三例患者40岁，下腹部疼痛八个月。超声和磁共振成像检查发现左侧卵巢和盆腔有多个实性 - 囊性肿物。随后的病理检查显示双侧卵巢、子宫后壁、肠道和左输尿管等多个区域有广泛的间质结节，提示诊断为低恶性潜能间质肉瘤。
合并多发性脓肿、血管平滑肌瘤或间质肉瘤的息肉样子宫内膜异位症相当罕见，需要积极的手术治疗。
