Radiographic Features of Intrinsic Ureteral Endometriosis: a case report

2005 
Endometriosis is defined as the presence of endometrial tissue in an ectopic position. It occasionally involves the urinary tract. Ureteral endometriosis may be either intrinsic or extrinsic, where the intrinsic ureteral endometriosis refers to disease caused by the actual invasion of the ureteral wall by the endometriosis. This form has often been mistaken for a primary ureteral neoplasm, with consequent nephroureterectomy. We reported a case of ureteral endometriosis in a 47 year-old female patient suffered from unilateral hydronephrosis. Left antegrade pyelography revealed a tubular filling defect in the left distal ureter with left hydronephrosis, and computed tomography (CT) demonstrated a soft tissue in the left distal ureter. Under the impression of malignant urothelial tumor, segmental resection of distal ureter was performed. The pathologic findings revealed elements of endometrial glands and stroma in the ureteral lumen. Extragenital intraureteral endometriosis was diagnosed. We should be aware of such diagnostic pitfalls to distinguish this lesion from polypoid ureteral tumor before operation.
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