Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens.
We report for the first time a case of 2.5 cm polypoid cervical endometriosis with a superficial growth pattern in a 48-year-old patient with past tubal ligation. The lesion showed metaplastic changes (clear cell, eosinophilic, micropapillary) and a prominent Arias Stella reaction in the absence of concomitant pregnancy but presumably related to phytoestrogenic treatment. The eutopic endometrium, however, had a usual proliferative appearance, implying that it showed a different response from the endometriotic tissues, suggesting the possibility of a metaplastic origin for the endocervical polypoid endometriosis. The unusual histology of the lesion led to an erroneous diagnosis of papillary serous carcinoma in the biopsy. This was subsequently excluded on finding endometrial-type stroma surrounding glands, and was confirmed immunohistochemically by a low Ki-67 index and negativity for p53.
Félix
Ana
A
Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Cedoc, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Paátria, Lisboa, Portugal. ana.felix@fcm.unl.pt
Nogales
Francisco F
FF
Arias-Stella
Javier
J
D003937:Diagnosis, Differential; D004715:Endometriosis / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008875:Middle Aged; D048789:Phytoestrogens / Q000008:administration & dosage*; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
D048789:Phytoestrogens