A rare case of rectovaginal endometriosis with lymph node involvement

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Reproductive Medicine

Background:

• Rectovaginal endometriosis is a common condition, but lymph node involvement is exceptionally rare.
• Endometrial tissue is typically found within the uterus, ovaries, and pelvic peritoneum.
• Pelvic lymph node metastasis from endometriosis is not a well-documented phenomenon.

Observation:

• A 44-year-old female presented with symptoms suggestive of rectovaginal endometriosis.
• Diagnostic workup revealed endometrial tissue within the pelvic lymph nodes.
• This presentation is unusual and warrants further investigation into the pathogenesis.

Findings:

• The presence of endometrial tissue in pelvic lymph nodes is a rare finding.
• Literature review confirms such occurrences primarily in patients with a history of endometriosis surgery.
• The case suggests lymphatic dissemination as the likely mechanism for lymph node involvement.

Implications:

• This case highlights the importance of considering endometriosis in the differential diagnosis of pelvic lymphadenopathy, even in rare presentations.
• Understanding the pathways of spread, such as lymphatic metastasis, is crucial for accurate diagnosis and management.
• Further research is needed to elucidate the mechanisms and clinical significance of endometriosis in pelvic lymph nodes.