Obstet Gynecol Sci.  2020 Jul;63(4):538-542. 10.5468/ogs.19245.

Pelvic malakoplakia presenting as endometrial cancer: a case report

• Cho JS
• Kim HI
• Lee JY
• Nam EJ
• Kim S
• Kim YT
• Kim SW

• KMID: 2505046
• DOI: http://doi.org/10.5468/ogs.19245

Abstract

Malakoplakia is a rare granulomatous, inflammatory disease generally manifesting as ulcers of the urogenital tract, especially in the bladder, but it can occur in any part of the body. Because of its varied clinical presentations, malakoplakia is considered for differential diagnosis upon suspicion. The final diagnosis is confirmed by the presence of Michaelis-Gutmann bodies. We report a case of pelvic malakoplakia accompanied by left lower quadrant pain that was misdiagnosed as endometrial cancer with pelvic mass based on imaging studies. The patient underwent dilatation and curettage, and the pathology report revealed no malignancy. Because of persistent pain and septic shock, she underwent a debulking operation to remove the mass. Histopathologic examination revealed malakoplakia. For postoperative management, she received broad-spectrum antibiotics, but abdominal pelvic computerized tomography performed on postoperative day 9 revealed pelvic mass recurrence. To the best of our knowledge, this is the only rare case report of pelvic malakoplakia mimicking endometrial cancer.

Keyword

Malakoplakia; Endometrial cancer; Pelvic inflammatory disease; Menopause

Figure

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  Fig. 1. (A) The patient’s preoperative abdominal pelvic computerized tomography (APCT) depicting the pelvic mass (coronal view and horizontal view). (B) Postoperative day #9 APCT depicting the recurred pelvic mass (coronal view and horizontal view).

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  Fig. 2. (A, B) Foamy epithelioid histiocytes and some lymphocytes in endomyometrium and pelvic cavity (A: hematoxylin and eosin [H&E] stain, ×100, B: H&E stain, ×200). (C) Histiocytes with basophilic bodies containing calcium (H&E stain, ×400). (D) Michaelis-Gutmann bodies noted (Von Kossa stain, ×400).

Reference

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