Pathology – Research and Practice 201 (2005) 527–530 TEACHING CASE Tumor-like manifestation of endosalpingiosis in uterus: a case report Karol Kajo a,Ã ,PavolZ ˇ u´bor b ,Katarı´naMacha´lekova´ a ,Luka´sˇ Plank a ,JozefVisˇnˇovsky` b a Department of Pathology, Jessenius Faculty of Medicine, Comenius University, Kollarova 2, 03601 Martin, Slovak Republic b Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University, Slovak Republic Received 7 December 2004; accepted 22 April 2005 Abstract Wereportona50-year-oldfemalepatientaffectedbybreastcancerandatumorouslesionlocatedinthesubserosal andintramuralpartoftheuterinefundus.Itconsistedofglandularandcysticformslinedwithepitheliumofthetubal type. We describe the clinical, macroscopic, and histological features of this rare non-neoplastic lesion, classified as florid endosalpingiosis (ES) and belonging to the spectrum of Mu¨llerian lesions. The discussion focuses on its morphologicalcharacteristics,thedifferentialdiagnosis,andthepotentialreasonsleadingtoitsorigin.Tothebestof our knowledge, this is the fifth case of florid ES of uterus reported in the English literature. r 2005 Elsevier GmbH. All rights reserved. Keywords: Uterus; Endosalpingiosis; Cyst Introduction ThesecondaryMu¨lleriansystemconsistsofstructures covering the peritoneal mesothelium, the adjacent mesenchyme in the small pelvis, and the lower part of the female abdominal cavity [2]. Proliferation of these structures may result in the creation of three different types of lesions. These include endometriosis, which occurs most frequently, and the less frequent endosal- pingiosis (ES) and endocervicosis. ES is a very rare lesion, and it is mainly detected incidentallyduringmicroscopicexaminationofmaterial obtained during operations in the abdominal cavity. Only rarely is ES detected at the clinical level. Some authorsdetectedESinectopicareas,e.g.inthecolonor the appendix [11].Thelast5yearshaveseenonlyafew cases of tumorous lesions of the uterus [4–6]. The presentation of our case is justified, because the lesion described here is extremely rare, and physicians should be prevented from rendering a false diagnosis, which is usually followed by invasive overtreatment. Clinical finding A 50-year-old woman (multipara, one abortion, withoutuseofHRT,negativePAPsmear,non-smoker), without any other remarkable gynecological, family- related, social and surgical history, was admitted to hospital for a palpable tumor mass in the left breast. Furthermore, clinical examination revealed a second palpable tumor in the small pelvis, located in the structures of left adnexa. An ultrasound transvaginal examination specified the site and the character of the tumor. It had a cystic structure and a size of 47mm diameter, with normal vascularity and velocimetry indices, localized close to the left side of the uterus. The patient underwent breast-saving conservative surgery for histologically verified invasive ductal breast ARTICLE IN PRESS www.elsevier.de/prp 0344-0338/$-see front matter r 2005 Elsevier GmbH. All rights reserved. doi:10.1016/j.prp.2005.04.010 Ã Corresponding author. Tel.: +4210434203874. E-mail address: karol.kajo@post.sk (K. Kajo).