Pelvic malakoplakia presenting as endometrial cancer: a case report

Cho, Jeong Soo; Kim, Hye In; Lee, Jung‐Yun; Nam, Eun Ji; Kim, Sung Hoon; Kim, Young Tae; Kim, Sang Wun

doi:10.5468/ogs.19245

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…8 Symptomatology is highly dependent upon the organ system involved, but presentation as a mass mimicking malignancy has been well described at multiple anatomical sites. [9][10][11][12][13] Although local recurrences may occur, MP usually follows an indolent clinical course, with good response to a combination of antibiotic therapy, surgical resection and/or reduction of immunosuppression. 14,15 However, exceptionally rare aggressive cases with fatal outcomes have been documented previously, mainly prior to the availability of newer antimicrobials.…”

Section: Discussionmentioning

confidence: 99%

“…MP has a predilection for patients with baseline immunosuppression and can be frankly symptomatic or clinically silent and diagnosed incidentally during the evaluation of other medical conditions 8 . Symptomatology is highly dependent upon the organ system involved, but presentation as a mass mimicking malignancy has been well described at multiple anatomical sites 9–13 . Although local recurrences may occur, MP usually follows an indolent clinical course, with good response to a combination of antibiotic therapy, surgical resection and/or reduction of immunosuppression 14,15 .…”

Section: Discussionmentioning

confidence: 99%

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Prostatic malakoplakia: clinicopathological assessment of a multi‐institutional series of 49 patients

et al. 2022

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Prostatic malakoplakia (MP) is rare, with only case reports and small series (< five patients) available in the literature. In this study we analysed an international multi‐institutional series of 49 patients with prostatic MP to more clearly define its clinicopathological features. The median age was 67 years and the median serum prostate‐specific antigen (PSA) was 7.5 ng/ml. MP was clinically manifest in most cases (28 of 45 patients with data available, 62%). Of 43 patients with detailed clinical history available, 21 (49%) had concurrent or metachronous malignancies (including prostate cancer). Diabetes or insulin resistance was present in 11 patients (26%). Additionally, three patients had a history of solid organ transplantation and one had HIV. Of note, six of 34 patients (18%) without concurrent prostate cancer had an abnormal digital rectal examination and/or lesions on magnetic resonance imaging (MRI) with prostate imaging reporting and data system (PIRADS) scores 4–5. The initial diagnosis was made on core biopsies (25 of 49, 51%), transurethal resection specimens (12 of 49, 24%), radical prostatectomies (10 of 49, 20%), Holmium‐laser enucleation (one of 49, 2%) and cystoprostatectomy (one of 49, 2%). Tissue involvement was more commonly diffuse or multifocal (40 of 49, 82%). Von Kossa and periodic acid‐Schiff stains were positive in 35 of 38 (92%) and 26 of 27 lesions (96%), respectively. Of note, two cases were received in consultation by the authors with a preliminary diagnosis of mesenchymal tumour/tumour of the specialised prostatic stroma. The present study suggests that prostatic MP is often associated with clinical findings that may mimic those of prostate cancer in a subset of patients. Moreover, MP may be found incidentally in patients with concurrent prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prostatic malakoplakia: clinicopathological assessment of a multi‐institutional series of 49 patients

et al. 2022

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Ovarian tumour-cutaneous fistula as a primary presentation of pelvic malakoplakia coexisting with a benign ovarian tumour mimicking advanced ovarian cancer

Aue-aungkul,

Muktabhant,

Kleebkaow

2024

BMJ Case Rep

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Malakoplakia is a rare granulomatous, chronic inflammatory disease generally affecting the urogenital organs, though it can arise in other organs. The clinical manifestations of malakoplakia vary depending on the affected organ. The final diagnosis is confirmed by the presence of Michaelis-Gutmann bodies on pathology. This report describes a case of pelvic malakoplakia accompanied by an ovarian tumour-cutaneous fistula, initially misdiagnosed as advanced ovarian cancer invading the anterior abdominal wall with left pleural effusion based on imaging studies and increased serum carbohydrate antigen 19-9. The patient underwent left thoracentesis and fluid collection from the fistula tract for cytology, which showed no malignancy. She underwent primary debulking surgery, including removal of the fistula tract from anterior abdominal wall. Histopathological examination revealed malakoplakia coexisting with mucinous cystadenoma of the left ovary. For postoperative management, she received prolonged oral antibiotics for 6 months. There was no evidence of disease recurrence at the 24-month follow-up.

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Malakoplakia of the Endometrium: A Rare Unexpected Disease Raising Clinical Concern for Malignancy

Fischer,

Jones,

et al. 2024

Int J Surg Pathol

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Malakoplakia is a rare disease that manifests as a histiocytic inflammatory process and most often occurs in the urinary bladder. It is caused by an impaired capacity of histiocytes to kill and digest bacteria. The typical histopathologic findings are sheets of histiocytes with granular eosinophilic cytoplasm and characteristic Michaelis–Gutmann bodies, spherical bodies with a targetoid appearance. Malakoplakia is even rarer in the gynecologic tract, and our literature search found only 21 published patients of malakoplakia involving the endometrium. Here we report a 60-year-old female patient who presented with recurrent pelvic infections and postmenopausal bleeding, which raised concern for an endometrial malignancy. Hysterectomy with salpingo-oophorectomy revealed malakoplakia involving the endometrium and also the right ovary. Michaelis–Gutmann bodies were visible on the intraoperative frozen section that was performed to rule out an endometrial malignancy. We summarize the clinicopathologic findings of the published patients of endometrial malakoplakia.

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Pelvic malakoplakia presenting as endometrial cancer: a case report

Cited by 3 publications

References 10 publications

Prostatic malakoplakia: clinicopathological assessment of a multi‐institutional series of 49 patients

Prostatic malakoplakia: clinicopathological assessment of a multi‐institutional series of 49 patients

Ovarian tumour-cutaneous fistula as a primary presentation of pelvic malakoplakia coexisting with a benign ovarian tumour mimicking advanced ovarian cancer

Malakoplakia of the Endometrium: A Rare Unexpected Disease Raising Clinical Concern for Malignancy

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