Polyp of the uterine cervix with heterologous fatty tissue

Benign Endocervical Polyp with Heterologous Elements in a 42-year-old Female: Report of a Case

“…That ECP showed benign overlying squamous epithelium, abnormal fibrous stroma with mature adipose tissue but no endocervical glands at all, which are histopathologic findings rather consistent with an angiolipomatous polyp [2]. Common histopathologic findings present in both reports by Ilhan and Pecorella [1,2], as well as the ECP we report herein, are mature adipocytes and thick-walled vessels. Furthermore, Ilhan et al noted the absence of an internal elastic lamina in the aforementioned vessels [1].…”

“…ECP with benign heterologous elements are extraordinarily rare. After a review of the English literature, two case reports, both describing ECP with mature adipose tissue and abnormal thick-walled vessels, were identified [1,2]. Ilhan and colleagues are first to report a 33-year-old female in which a hamartomatous ECP demonstrated mature cartilage and adipose tissue; in addition, focal pseudodecidual change and mesonephric glands were seen [1].…”

“…Given the presence of mesonephric glands, this polyp could have represented a benign mixed Müllerian tumor, such as lipoadenofibroma - another rare entity. More recently, Pecorella et al described a second similar polypoid lesion in a 24-year-old female [2]. That ECP showed benign overlying squamous epithelium, abnormal fibrous stroma with mature adipose tissue but no endocervical glands at all, which are histopathologic findings rather consistent with an angiolipomatous polyp [2].…”

“…More recently, Pecorella et al described a second similar polypoid lesion in a 24-year-old female [2]. That ECP showed benign overlying squamous epithelium, abnormal fibrous stroma with mature adipose tissue but no endocervical glands at all, which are histopathologic findings rather consistent with an angiolipomatous polyp [2]. Common histopathologic findings present in both reports by Ilhan and Pecorella [1,2], as well as the ECP we report herein, are mature adipocytes and thick-walled vessels.…”

“…The identification of choristomatous ECP with the unusual and rare finding of adipocytes, cartilage, and abnormal large vessels within the stroma can be worrisome to the practicing pathologist. When obvious endocervical glands are not identified within the polyp, as illustrated by Pecorella, or mesonephric glands are noted, as per Ilhan [1,2], the diagnosis may become even more challenging. Most importantly, the identification of hamartomatous elements should prompt the pathologist to exclude other mimickers, particularly malignant neoplasms.…”