初診時に子宮奇形を疑った子宮頸部polypoid endometriosisの一例

抄録

  Polypoid endometriosis is an uncommon and distinctive variant of endometriosis. It was first described by Mostoufizadeh and Scully in 1980. Polypoid endometriosis often forms large multiple masses and mimics malignant tumors. Endometriosis typically affects women of reproductive age; however, polypoid endometriosis commonly occurs in older women. We report a case of polypoid endometriosis that occurred in a very young female; it arose from the cervix and extended into the Pouch of Douglas. Although it mimicked a uterine malformation on ultrasound at patient presentation, a correct diagnosis was made by magnetic resonance imaging (MRI) and laparoscopic surgery. The patient is a 16-year-old nulliparous female with an intact hymen. One month prior to presentation at our hospital, she experienced severe lower abdominal pain, fever of 39° Celsius, and heavy menses with clots. This incident represented her first episode of dysmenorrhea and hypermenorrhea. The symptoms resolved spontaneously; however, one month later, she again experienced dysmenorrhea and presented at our facility. A uterine malformation such as a bicornuate uterus was suspected on transrectal ultrasound; however, MRI and laparoscopic surgery revealed polypoid endometriosis of the cervix. The symptoms resolved after excision of the lesion. Postoperatively, she has received oral contraceptive therapy for eight months; the condition has not recurred. When a uterine malformation is suspected on ultrasound, a rare condition such as polypoid endometriosis may be diagnosed by MRI or laparoscopic surgery.