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2015 ; 8
(3
): 3370-3
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Nodular smooth muscle metaplasia in multiple peritoneal endometriosis
#MMPMID26045871
Kim HS
; Yoon G
; Ha SY
; Song SY
Int J Clin Exp Pathol
2015[]; 8
(3
): 3370-3
PMID26045871
show ga
We report here an unusual presentation of peritoneal endometriosis with smooth
muscle metaplasia as multiple protruding masses on the lateral pelvic wall.
Smooth muscle metaplasia is a common finding in rectovaginal endometriosis,
whereas in peritoneal endometriosis, smooth muscle metaplasia is uncommon and its
nodular presentation on the pelvic wall is even rarer. To the best of our
knowledge, this is the first case of nodular smooth muscle metaplasia occurring
in peritoneal endometriosis. As observed in this case, when performing
laparoscopic surgery in order to excise malignant tumors of intra-abdominal or
pelvic organs, it can be difficult for surgeons to distinguish the metastatic
tumors from benign nodular pelvic wall lesions, including endometriosis, based on
the gross findings only. Therefore, an intraoperative frozen section biopsy of
the pelvic wall nodules should be performed to evaluate the peritoneal
involvement by malignant tumors. Moreover, this report implies that peritoneal
endometriosis, as well as rectovaginal endometriosis, can clinically present as
nodular lesions if obvious smooth muscle metaplasia is present. The pathological
investigation of smooth muscle cells in peritoneal lesions can contribute not
only to the precise diagnosis but also to the structure and function of smooth
muscle cells and related cells involved in the histogenesis of peritoneal
endometriosis.