# Postoperative diagnosis of uterine florid cystic endosalpingiosis: a case report emphasizing diagnostic challenges and multimodal imaging correlation

## TL;DR

This case report describes a rare benign uterine condition diagnosed after surgery, emphasizing the importance of accurate imaging and avoiding unnecessary treatments.

## Contribution

The first documented case of florid cystic endosalpingiosis confined to the uterine myometrium without pelvic pathology.

## Key findings

- Histopathological analysis confirmed benign cystic endosalpingiosis in the uterine myometrium.
- No recurrence was observed over a 6-year follow-up period.
- Multimodal imaging and histopathology are critical for distinguishing benign from malignant uterine lesions.

## Abstract

Endosalpingiosis, a rare benign condition characterized by ectopic fallopian tube-like epithelium, often coexists with endometriosis. This case report presents a unique instance of florid cystic endosalpingiosis confined to the uterine myometrium—marking the first documented case without associated pelvic pathology. Using multimodal imaging and histopathological analysis, we highlight key diagnostic approaches to distinguish this condition from malignant mimics.

A 47-year-old woman with a 2-year history of chronic pelvic pain and recent irregular bleeding underwent surgical exploration after imaging revealed isolated, non-communicating cystic lesions within the myometrium. Histopathological examination identified cyst walls lined with ciliated pseudostratified epithelium, confirmed as benign through immunohistochemistry. A 6-year follow-up showed no evidence of recurrence.

Florid cystic endosalpingiosis should be considered in the differential diagnosis of cystic uterine lesions. Establishing standardized imaging criteria and adopting fertility-preserving management strategies can help avoid unnecessary radical interventions, optimizing outcomes for premenopausal women.