Endosalpingiosis: Clinical Presentation and Coexisting Pathology [07H

Abstract

INTRODUCTION: Describe the clinical presentation and coexisting pathology of women with endosalpingiosis (ES), the presence of ectopic fallopian tube-like epithelium. METHODS: Retrospective analysis of pathology reports containing the keyword “endosalpingiosis” for procedures performed at the University of Kansas Medical Center between 2007-2017 Demographic information, clinical characteristics, and relevant pathology were collected for patients (N=98) with pathologically confirmed ES. RESULTS: Patient Characteristics: the cohort had a mean age of 51 at diagnosis, 52% were post-menopausal, 52% were never smokers, their mean BMI was 32, and 59% had prior abdominal or pelvic surgery. Clinical Presentation: 43% complained of pelvic pain, 31% of the post-menopausal subgroup presented with bleeding, and 26% experienced abdominal pain or bloating. Abdominal or pelvic mass was the most frequent indication for surgery (35%), followed by evaluation of a known gynecologic malignancy (31%) of which 60% were endometrial adenocarcinoma. Pathology Findings: 79% of patients had a single ES lesion on biopsy most likely to be found in an abdominal or pelvic lymph node (38%), ovary (21%), and perimetrium (14%). All 98 women in the cohort had other pathology in addition to ES. A new gynecologic malignancy was diagnosed after surgery in 29% of which 62% were ovarian. The majority also presented with concomitant benign disease (cyst, leiomyoma, etc) and 19% had concurrent endometriosis. CONCLUSION: Women with ES commonly complain of pelvic pain and the majority have a concurrent gynecologic cancer. It appears ES rarely occurs in isolation and further research is necessary to determine its role in the pathogenesis of gynecologic disease.