Focal Atypical Endometrial Hyperplasia Arising Within a Deeply Infiltrating Bladder Endometriotic Nodule

Area of Science:

• Gynecologic pathology
• Surgical oncology
• Reproductive medicine

Background:

• Deeply infiltrating endometriosis can affect the bladder, posing diagnostic and therapeutic challenges.
• Extrauterine endometriosis, particularly in the bladder, requires thorough evaluation due to potential for atypia.
• Atypical endometrial hyperplasia in endometriosis is uncommon but significant for patient management.

Purpose of the Study:

• To report a case of deeply infiltrating bladder endometriosis with focal atypical endometrial hyperplasia.
• To emphasize the importance of meticulous surgical and histological assessment in complex endometriosis.
• To discuss individualized management and surveillance for extrauterine endometriosis with atypia.

Main Methods:

• Laparoscopic excision with partial cystectomy for deeply infiltrating bladder endometriosis.
• Histopathological examination of the excised bladder nodule.
• Review of literature on bladder endometriosis and atypical endometrial hyperplasia.

Main Results:

• Successful surgical excision of deeply infiltrating bladder endometriosis.
• Histopathological diagnosis of focal atypical endometrial hyperplasia within the bladder endometriotic nodule.
• Confirmation of the complexity in managing such cases.

Conclusions:

• Thorough surgical planning and complete excision are crucial for deeply infiltrating bladder endometriosis.
• Histological assessment is vital for identifying atypia in extrauterine endometriosis.
• Individualized management and surveillance are necessary when atypia is found in endometriosis outside the uterus.