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

Pelvic malakoplakia presenting as endometrial cancer: a case report

Affiliations
  • 1Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea

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

  • 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).

  • 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

References

1. Stanton MJ, Maxted W. Malacoplakia: a study of the literature and current concepts of pathogenesis, diagnosis and treatment. J Urol. 1981; 125:139–46.
Article
2. Biggar WD, Crawford L, Cardella C, Bear RA, Gladman D, Reynolds WJ. Malakoplakia and immunosuppressive therapy. Reversal of clinical and leukocyte abnormalities after withdrawal of prednisone and azathioprine. Am J Pathol. 1985; 119:5–11.
3. Lewin KJ, Fair WR, Steigbigel RT, Winberg CD, Droller MJ. Clinical and laboratory studies into the pathogenesis of malacoplakia. J Clin Pathol. 1976; 29:354–63.
Article
4. Bansal SS, Jokhi VH, Ponde SV, Kaushik N, Sonawane C. Malakoplakia of proximal tibia- A case report. J Orthop Case Rep. 2014; 4:78–80.
5. Dias PH, Slongo LE, Romero FR, Paques GR, Gomes RP, Rocha LC. Retroperitoneal sarcoma-like malakoplakia. Rev Assoc Med Bras (1992). 2011; 57:615–6.
Article
6. Chou SC, Wang JS, Tseng HH. Malacoplakia of the ovary, fallopian tube and uterus: a case associated with diabetes mellitus. Pathol Int. 2002; 52:789–93.
Article
7. Aikat BK, Radhakrishnan VV, Rao MS. Malakoplakia--a report of two cases with review of the literature. Indian J Pathol Bacteriol. 1973; 16:64–70.
8. Lou TY, Teplitz C. Malakoplakia: pathogenesis and ultrastructural morphogenesis. A problem of altered macrophage (phagolysosomal) response. Hum Pathol. 1974; 5:191–207.
9. Hina S, Hasan A, Iqbal N, Shabbir MU, Sheikh AA. Malakoplakia of the urinary bladder and unilateral ureter. J Coll Physicians Surg Pak. 2019; 29:582–4.
Article
10. Mitchell A, Dugas A. Malakoplakia of the colon following renal transplantation in a 73year old woman: report of a case presenting as intestinal perforation. Diagn Pathol. 2019; 14:22.
Article
11. Dong H, Dawes S, Philip J, Chaudhri S, Subramonian K. Malakoplakia of the urogenital tract. Urol Case Rep. 2014; 3:6–8.
Article
Full Text Links
  • OGS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr