[Multicentric Florid Cystic Endosalpingiosis in Different Anatomical Spaces: A Case Report]

Abstract

Endosalpingiosis is a condition that causes the non-neoplastic proliferation of ectopic tubal epithelium. Florid cystic endosalpingiosis is an atypical subtype that is very rarely reported. It presents as a mass-like feature and therefore needs to be differentiated from tumorous conditions. Here, we report the imaging findings of a case of multicentric florid cystic endosalpingiosis in the extraperitoneal pelvic cavity and the retroperitoneal spaces.

Fig. 1. Extraperitoneal and retroperitoneal florid cystic endosalpingiosis in a 48-year-old female.

A. Axial and coronal contrast-enhanced CT images show two cystic lesions in the retroperitoneal space (upper left image) and extraperitoneal pelvic cavity (upper right image). The cystic lesions display unevenly thick enhancing walls (arrowheads, the upper cystic lesion; arrows, the lower cystic lesion). B. The axial T2-weighted MR image shows a unilocular cystic lesion (arrows; B, C) with homogenous fluid signal intensity. C. Axial precontrast T1-weighted MR image displays mass with homogenesly low signal intensity. D. Axial contrast-enhanced T1-weighted MR images show two extraperitoneal or retroperitoneal cystic lesions (arrows), including multifocal wall thickening with enhancement in the retroperitoneal space (left image) and the extraperitoneal cavity (right image). The upper cystic lesion shows a cyst-in-cyst feature due to small mural cysts (arrowheads, left image). E. Histopathology confirms the lesions as endosalpingiosis, which are lined by ciliated cuboidal or columnar epithelium with a morphology resembling fallopian tube epithelium. Smooth muscle hyperplasia is also noted in the cyst wall (hematoxylin-eosin stain, × 400).