Appendiceal endosalpingiosis: clinical presentation and imaging appearance of a rare condition of the appendix

Abstract

Endosalpingiosis rarely affects the appendix but can be mistaken for acute appendicitis or appendiceal tumors. The medical literature regarding appendiceal endosalpingiosis is sparse; consisting of only four case reports which are primarily focused on the histopathology but provide little radiologic correlation. Endosalpingiosis is a rare condition characterized by the presence of benign fallopian tubal-like glandular epithelium derived from Mullerian ducts, usually affecting the serosal surfaces of the pelvis and peritoneum. It is histologically differentiated from endometriosis as endosalpingiosis lacks endometrial stroma. Endosalpingiosis tends to affect older women and has been associated with ovarian serous tumors of low malignant potential. After a retrospective review of a pathology database, we present pathologically proven cases of appendiceal endosalpingiosis with correlative imaging. We discuss the clinical presentation, illustrate the CT and MRI appearance, histologic characteristics, and review the current medical literature of appendiceal endosalpingiosis.

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References

  1. 1.

    Prentice L, Stewart A, Mohiuddin S, Johnson NP (2012) What is endosalpingiosis? Fertil Steril 98(4):942–947. https://doi.org/10.1016/j.fertnstert.2012.06.039

    Article  PubMed  Google Scholar 

  2. 2.

    Pollheimer MJ, Leibl S, Pollheimer VS, Ratschek M, Langner C (2007) Cystic endosalpingiosis of the appendix. Virchows Arch 450(2):239–241. https://doi.org/10.1007/s00428-006-0328-9

    Article  PubMed  Google Scholar 

  3. 3.

    Demir MK, Savas Y, Furuncuoglu Y, et al. (2017) Imaging findings of the unusual presentations, associations and clinical mimics of acute appendicitis. Eurasian J Med 49(3):198–203. https://doi.org/10.5152/eurasianjmed.2017.17218

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Sampson JA (1930) Post salpingectomy endometriosis (endosalpingiosis). Am J Obstet Gynecol 20:443–480

    Article  Google Scholar 

  5. 5.

    Tallón-Aguilar L, Olano-Acosta C, López-Porras M, Flores-Cortés M, Pareja-Ciuró F (2009) Endosalpingiosis of the appendix. Cir Esp 85(6):383. https://doi.org/10.1016/j.ciresp.2008.09.017

    Article  PubMed  Google Scholar 

  6. 6.

    Djordjevic B, Clement-Kruzel S, Atkinson NE, Malpica A (2010) Nodal endosalpingiosis in ovarian serous tumors of low malignant potential with lymph node involvement: a case for a precursor lesion. Am J Surg Pathol 34(10):1442–1448. https://doi.org/10.1097/PAS.0b013e3181f17d33

    Article  PubMed  Google Scholar 

  7. 7.

    Katre R, Morani AK, Prasad SR, et al. (2010) Tumors and pseudotumors of the secondary Mullerian system: review with emphasis on cross-sectional imaging findings. AJR 195(6):1452–1459. https://doi.org/10.2214/AJR.10.4302

    Article  PubMed  Google Scholar 

  8. 8.

    Esselen KM, Terry KL, Samuel A, et al. (2016) Endosalpingiosis: more than just an incidental finding at the time of gynecologic surgery? Gynecol Oncol 142(2):255–260. https://doi.org/10.1016/j.ygyno.2016.05.036

    Article  PubMed  Google Scholar 

  9. 9.

    Irving JA, Young RH, Clement PB (2015) Sternberg’s diagnostic surgical pathology, 6th edn. The Netherlands: Wolters Kluwer Health

    Google Scholar 

  10. 10.

    Kaneda S, Fujii S, Nosaka K, et al. (2015) MR imaging findings of mass-forming endosalpingiosis in both ovaries: a case report. Abdom Imaging 40(3):471–474. https://doi.org/10.1007/s00261-014-0327-2

    Article  PubMed  Google Scholar 

  11. 11.

    Cajigas A, Axiotis CA (1990) Endosalpingiosis of the vermiform appendix. Int J Gynecol Pathol 9(3):291–295

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Ryuko K, Miura H, Abu-Musa A, Iwanari O, Kitao M (1992) Endosalpingiosis in association with ovarian surface papillary tumor of borderline malignancy. Gynecol Oncol 46(1):107–110

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Todd R. Williams.

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No grants or funding was involved in this project.

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All authors (Drs. Tudor, Williams, Myers and Umar) declare no conflicts of interest.

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The study is a retrospective review of the medical record and is compliant with Henry Ford. Hospital’s Institutional Review Board guidelines (IRB# 12225) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study (retrospective review) formal consent is not required.

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This article does not contain studies with human or animal participants performed by any of the authors.

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Tudor, J., Williams, T.R., Myers, D.T. et al. Appendiceal endosalpingiosis: clinical presentation and imaging appearance of a rare condition of the appendix. Abdom Radiol 44, 3246–3251 (2019). https://doi.org/10.1007/s00261-018-1813-8

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Keywords

  • Appendix
  • Endosalpingiosis
  • Endometriosis
  • Appendicitis
  • Tumors