Fertility preservation of polypoid endometriosis: Case series and literature review

Abstract

Polypoid endometriosis (PE) is a rare distinctive variant of endometriosis with morphological features resembling malignant tumors. Although a surgical procedure is usually performed for the treatment and diagnosis of PE, fertility preservation is usually desired in cases of reproductive age. However, there have been no reports of fertility-preserving treatments resulting in live births. In this study, we report three cases of PE that were diagnosed preoperatively or intraoperatively, leading to fertility preservation. Intraoperative pathological diagnosis, hysteroscopy, and hormone therapy before treatment were useful for preoperative diagnosis in the three cases. Two of the three patients got pregnant and the pregnancy progressed to a live birth. We also performed a literature review to identify the clinical characteristics indicative of the preoperative diagnosis of PE.

Rapidly growing extensive polypoid endometriosis after gonadotropin-releasing hormone agonist discontinuation: A case report

“…The polypoid area was similar to the endometrial signal, with moderate to high intensity on T2WI, and the mass margins were surrounded by T2 hypointensity. However, small haemorrhagic foci in the mass are hyperintense on T1WI and slightly increased on diffusion-weighted imaging, and no imaging features of malignancy, such as lymphadenopathy, are present[ 19 , 20 ]. A few larger lesions may exhibit diffuse, uniform, finely divided-like changes.…”