Intraureteral endometriosis imitating intraureteral carcinoma

Abstract

Endometriosis involves occasionally the urinary tract. Ureter obstruction is a rare complications of this condition. We report a 48 years old female patient suffering from intermittent hematuria and unilateral hydronephrosis. As X-ray and ultrasound examination revealed obstruction at the middle part of the left ureter, which was highly suspicious for a carcinoma, a nephrectomy was performed. The microscopic examination of the specimens revealed submucous polypoid endometroid islets in the ureteral lumen. Extragenital intraureteral endometriosis was diagnosed. The surface epithelium covering the endometroid isles showed severe atypia. Pathologist could be afforded to distinguish this lesion from polypoid growing urothelial tumors and so they should be aware of such diagnostic pitfalls.