PMC6590549_01
MRI findings of (a) the abdomen and (b) the pelvis with T2-weighted images: white arrows: left ureter and black arrows: a postperitoneal tumor.
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Magnetic resonance imaging (MRI) of the abdomen and pelvic cavity also exhibited a 4 cm mass and left hydronephrosis (Figure 1).
(a) The pelvic mass encasing with left ureter observed in surgery and (b) macroscopic the resected tissue after formalin-fixation.
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Left ureter, sigmoid colon and uterus were involved with the tumor (Figure 2).
H.E. staining of the tissue diagnosed as the malignant transformation of ureteral endometriosis. (a) The endometrioid carcinoma adjacent to endometriotic tissue was observed (x40). In the photograph (a), the locations of (B) the endometriotic tissue with necrotic tissue found in the dotted area after the chemotherapy (x100), (C) the endometrioid carcinoma (x100), and (D) the atypical endometriosis (x400) were indicated.
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Pathological examination proved the tissue of ureteral endometriosis adjacent to the malignant tissues (Figures 3(a)-3(d)). The endometriotic tissue with necrotic tissue influenced possibly by the chemotherapy (Figure 3(b)), and the endometrioid adenocarcinoma (Figure 3(c)), and the part of atypical endometriosis, which are considered to be the precancerous lesion were observed (Figure 3(d)). These features were consistent with the diagnosis of well differentiated endometrioid adenocarcinoma (Grade 1 FIGO), surrounded with endometriotic tissue (Figure 3(a)).