Journal of Pathology and Translational Medicine

Case Study

Extrapelvic Uterus-like Masses Presenting as Colonic Submucosal Tumor: A Case Study and Review of Literature: Ki Yong Na, Gou Young Kim, Kyu Yeoun Won, Hyun-Soo Kim, Sang Won Kim, Chi Hoon Lee, Jae Myung Cha; Korean J Pathol. 2013;47(2):177-181. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.177

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A uterus-like mass (ULM) is a central cavity lined by endometrial glands and stroma and surrounded by thick-walled smooth muscles. To date, 31 cases of ULM have been reported in the English literature. ULM typically presents as a single mass and is located in the pelvic cavity. We report here a very rare case of multiple extrapelvic ULMs involving the cecum, descending colon, and mesocolon. After extensive literature research, our case appears to be the first case of multiple ULMs found in extrapelvic sites and the first case of ULM in the colon. The present case suggests that ULM should be included in the differential diagnosis of colonic submucosal tumors in female patients with chronic abdominal pain or menstruation-associated symptoms.

Citations

Citations to this article as recorded by

Extrauterine adenomyoma: A case report and systematic review of the literature
Matteo Giorgi, Luca Labanca, Gabriele Centini, Lucia Lazzeri, Francesco Giuseppe Martire, Ester Sorrentino, Virginia Mancini, Diego Raimondo, Antonio Raffone, Daniele Neola, Anna Chiara Aru, Nassir Habib, Paolo Casadio, Renato Seracchioli, Errico Zupi
International Journal of Gynecology & Obstetrics.2024; 164(3): 869. CrossRef
Extrapelvic “Uterus Like Mass” Following Laparoscopic Morcellation Hysterectomy - a Consequence of Iatrogenic Implantation?
Neha Bakshi, Shashi Dhawan
International Journal of Surgical Pathology.2023; 31(5): 791. CrossRef
Extrauterine adenomyoma of the lesser omentum: A case report and review of the literature
Yanlin Chen, Liangyong Deng, Jingbo Zhao, Tianwen Luo, Zhong Zuo
Medicine.2022; 101(36): e30240. CrossRef
Pelvic Pain and Adnexal Mass: Be Aware of Accessory and Cavitated Uterine Mass
Pooya Iranpour, Sara Haseli, Pedram Keshavarz, Amirreza Dehghanian, Neda Khalili, Michael S. Firstenberg
Case Reports in Medicine.2021; 2021: 1. CrossRef
Endomyometriosis of the Rectum With Disseminated Peritoneal Leiomyomatosis 8 Years After Laparoscopic Myomectomy: A Case Report
Giorgio La Greca, Cristina Colarossi, Paolo Di Mattia, Cecilia Gozzo, Marco De Zuanni, Eliana Piombino, Lorenzo Memeo
Frontiers in Surgery.2021;[Epub] CrossRef
Imaging Manifestations of Accessory Cavitated Uterine Mass—A Rare Mullerian Anomaly
Tharani Putta, Reetu John, Betty Simon, Kirthi Sathyakumar, Anuradha Chandramohan, Anu Eapen
Indian Journal of Radiology and Imaging.2021; 31(03): 545. CrossRef
A rare case of ovarian adenomyoma mimicking primary invasive ovarian cancer with a contralateral serous borderline ovarian tumor: A case report and review of the literature
Viola Liberale, Alessandra Surace, Lorenzo Daniele, Luca Liban Mariani
Heliyon.2020; 6(7): e04406. CrossRef
Extrauterine adenomyoma located in the inguinal region: a case report of a 44-year-old woman
Winesh Ramphal, Chloé M L Peters, Luthy S M Alcalá, Dennis van Hamont, Paul D Gobardhan
Journal of Surgical Case Reports.2020;[Epub] CrossRef
Accessory and Cavitated Uterine Mass: Is It a Müllerian-Duct Anomaly?
Vani Malhotra, Sonia Dahiya, Smiti Nanda, Meenakshi Chauhan, Vandana Bhuria
Journal of Gynecologic Surgery.2020; 36(6): 350. CrossRef
Uterus-like mass in the right broad ligament
Lei Liu, Hui Yang, Shu-Peng Zhang
Medicine.2019; 98(38): e17246. CrossRef
Extrauterine adenomyoma: a review of the literature
P.G. Paul, Gunjan Gulati, Hemant Shintre, Sumina Mannur, George Paul, Santwan Mehta
European Journal of Obstetrics & Gynecology and Reproductive Biology.2018; 228: 130. CrossRef
Uterus-like mass
Jian He, Jie Xu, Hong-Yan Zhou
Medicine.2016; 95(39): e4961. CrossRef
Endometrioid Adenocarcinoma in an Extrauterine Adenomyoma
Michael A. Ulm, David B. Robins, Edwin M. Thorpe, Mark E. Reed
Obstetrics & Gynecology.2014; 124(2): 445. CrossRef
Endomyometriosis (“Uterus - like mass”) in an XY Male
Raul S. González, Cindy L. Vnencak-Jones, Chanjuan Shi, Oluwole Fadare
International Journal of Surgical Pathology.2014; 22(5): 421. CrossRef

Case Reports

Atypical Polypoid Adenomyomas of the Endometrium: 2 case reports.: Hee Jeong Ahn, Kyu Rae Kim, Yoon Jung Choi, Bok Soo Kim; Korean J Pathol. 1996;30(11):1034-1039.

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Abstract PDF: Atypical polypoid adenomyoma(APA) is a rare benign polypoid tumor arising in the uterine endometrium which was first designated by Mazur in 1981. Microscopic examination reveals architecturally and cytologically atypical endometrial glands separated by intersecting fascicles of smooth muscle cells. The tumor can be misdiagnosed as endometrial adenocarcinoma with myometrial invasion, especially on microscopic examination of a curettage specimen. However a granulation tissue-like stromal response is absent and the smooth muscle in APA is more cellular than that of normal myometrium. We are reporting 2 cases of APA of the uterine endometrium which are 1.5 cm and 1.7 cm in size, respectively, in a 30 and a 22 year-old women. This is the first report in Korean literature using the immunohistochemical staining for smooth muscle actin and desmin.

Adenomyoma of Endocervical Type in a First-Trimester Gravid Uterine Corpus: A Brief Report.: Hyunchul Kim, Hoiseon Jeong, Sangho Lee, Young Seok Lee, Bong Kyung Shin, Insun Kim; Korean J Pathol. 2008;42(2):123-124.

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Abstract PDF: Uterine adenomyoma is a neoplasm that is composed of endometrial glands and smooth muscle, and this is found in the uterine corpus; however, the glandular component is occasionally of mucin-secreting endocervical type. We describe here a case of uterine adenomyoma of the endocervical type, and this presented in a 38-year-old pregnant woman.

Uterus-Like Mass with Features of an Extrauterine Adenomyoma: A Case Report and Literature Review.: Mi Jin Kim, Sang Hee Seok; Korean J Pathol. 2007;41(5):347-351.

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Abstract PDF: Uterus-like masses, such as cavities lined by endometrium-type mucosa surrounded by bundles of smooth muscle cells, may strikingly resemble the uterus. In this report, we describe a case of a uterus-like mass with features of an extrauterine adenomyoma in a 42-year-old woman. The first uterine-like mass was documented by Cozzutto in 1981 and to date, 13 such cases have been reported. Three theories have been offered to explain their etiology: 1) the uterine/Mullerian duct fusion defect theory, which is based on a developmental abnormality occurring during the formation of the female genital tract, 2) the metaplastic theory, which is based on the fact that a uterus-like mass may arise from subperitoneal mesenchymal cells that retain the ability to duplicate Mullerian duct structures, and 3) the heterotopia theory. We consider that the metaplastic theory best fits with our observations in the present case as both glandular and stromal smooth muscle cells proliferated as a true neoplasm rather than as an anomaly.

Adenomyoma of Ampulla of Vater or the Common Bile Duct: A Report of Three Cases.: Kee Taek Jang, Jin Seok Heo, Seoung Ho Choi, Dong Il Choi, Jae Hoon Lim, Young Lyun Oh, Geung Hwan Ahn; Korean J Pathol. 2005;39(1):59-62.

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Abstract PDF: Adenomyoma is a rare non-neoplastic lesion of the biliary tract. Here we report on three cases of adenomyoma; one located in the ampulla of Vater and two located in the common bile duct. Although preoperative endoscopic and radiological evaluations could not determine whether lesions were benign or malignant, intra-operative frozen section histologic examinations aided the differential diagnosis. Microscopic features of a lobular gland architecture with basally located nuclei and the absence of desmoplastic stromal reaction were found to be characteristic in frozen and paraffin sections.

Original Article

Histologic Variations of Intramural Heterotopic Pancreas in Gastrointestinal Tract Analysis of 15 Cases.: Seung Sook Lee, Yong Il Kim, Woo Ho Kim, Eun Sil Yu; Korean J Pathol. 1991;25(6):520-527.

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Abstract PDF: We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.

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