Polypoid Endometriosis Presenting as a Renal Cortical Tumor

Area of Science:

• Gynecologic Pathology
• Urologic Oncology
• Medical Imaging

Background:

• Polypoid endometriosis is an uncommon condition characterized by endometrial tissue growth outside the uterus.
• It can present as a distinct mass, making differential diagnosis challenging.
• This condition is often mistaken for neoplastic processes, particularly in the genitourinary tract.

Observation:

• A 41-year-old female presented with left flank pain and gross hematuria.
• Imaging revealed a large, solid, enhancing left kidney mass, suspicious for renal cell carcinoma.
• The patient's symptoms were unrelated to her menstrual cycle, further complicating the initial assessment.

Findings:

• Histopathological examination post-surgical resection confirmed the mass to be polypoid endometriosis.
• The resected tissue showed features consistent with endometriosis, not malignancy.
• This highlights the potential for endometriosis to present as a solid organ mass.

Implications:

• Polypoid endometriosis requires a high index of suspicion in women presenting with unexplained abdominal or flank masses.
• It underscores the importance of comprehensive histopathological evaluation to differentiate benign conditions from malignancies.
• Accurate diagnosis through imaging and pathology is crucial for appropriate management, avoiding unnecessary aggressive treatments.