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Polypoid endometriosis: a mimic of malignancy

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Abstract

This an interesting case of an asymptomatic 60-year-old postmenopausal patient with an incidental pelvic mass mimicking a pelvic malignancy on imaging. Biopsy revealed findings consistent with polypoid endometriosis. After discontinuation of hormone replacement therapy, the mass showed decrease in size on follow-up imaging. Polypoid endometriosis is a rare but distinct variant of endometriosis with histopathologic features akin to an endometrial polyp. Clinical and imaging features of polypoid endometriosis differ from classic endometriosis. While classic endometriosis predominates in premenopausal women, polypoid endometriosis more commonly affects peri- to postmenopausal women and is associated with the exposure to Tamoxifen or hormone replacement therapy. Imaging features that aid in the diagnosis of polypoid endometriosis are a T2 hyperintense polypoid mass with signal characteristics similar to endometrium, a T2 hypointense peripheral rim, contrast enhancement pattern mirroring the enhancement of the endometrium, and lack of diffusion restriction. Radiologists should be familiar with polypoid endometriosis because this clinically and morphologically distinct variant may mimic malignant neoplasms on imaging.

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Acknowledgements

We thank Joanne Chin for her editorial support of this manuscript.

Funding

This work was supported in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Soleen Ghafoor, Yulia Lakhman & Iva Petkovska

  2. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kay J. Park

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  1. Soleen Ghafoor
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  2. Yulia Lakhman
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Correspondence to Soleen Ghafoor or Iva Petkovska.

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Ghafoor, S., Lakhman, Y., Park, K.J. et al. Polypoid endometriosis: a mimic of malignancy. Abdom Radiol 45, 1776–1782 (2020). https://doi.org/10.1007/s00261-019-02143-8

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