Table of Contents
Definition / general | Epidemiology | Sites | Etiology | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosisCite this page: Chaux A. Endocervicosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderendocervicosis.html. Accessed April 13th, 2021.
Definition / general
- Rare benign tumor-like lesions characterized by prominent endocervical-type glands in muscularis propria
Epidemiology
- Women in reproductive years (mean age 39 years, range 34-65 years)
- Also men receiving estrogen for prostate cancer
Sites
- Posterior wall or posterior dome preferentially affected
Etiology
- Müllerian origin (Am J Surg Pathol 1992;16:533)
Clinical features
- Benign behavior (Hum Pathol 1996;27:816)
- Associated with endometriosis and cesarean section
Case reports
- 36 year old woman with chronic pelvic pain (Arch Pathol Lab Med 2005;129:e109)
- 67 year old woman with solid bladder wall mass (Int J Clin Exp Pathol 2009;2:91)
Treatment
- Excision
Gross description
- Mass between bladder and uterus in posterior bladder wall, dome or trigone
- Up to 2.5 to 3.0 cm in size
- Spongy cut surface with mucinous / milky fluid
Microscopic (histologic) description
- Irregular proliferation of prominent endocervical-type glands in muscularis propria, less frequently in lamina propria or subserosal connective tissue
- Glands are irregular in size and shape and may be cystically dilated, containing mucinous secretions with neutrophils
- Glands are lined by a single layer of tall mucinous columnar cells, less commonly flat or cuboidal cells, rarely ciliated or goblet-like cells
- Focal glandular rupture leads to mucin accumulation within the stroma with a fibroblastic-histiocytic response
- Absent or mild nuclear atypia, no mitotic figures
- No desmoplasia, no glandular crowding or back-to-back architecture
Microscopic (histologic) images
Positive stains
- ER, PR, HBME1 (Pathol Res Pract 2002;198:115)
Differential diagnosis
- Adenocarcinoma: marked atypia, mitotic figures
- Adenoma malignum from uterine cervix: infiltration of bladder serosa, deep cervical involvement, glands are variable in shape or size with irregular or claw-shaped outlines