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Müllerianosis of the urinary bladder is a rare pathological condition involving ectopic Müllerian-derived tissues within the bladder. Despite its benign nature, due to its ability to mimic malignant conditions such as bladder carcinoma, diagnosis might be challenging. In this review, data from 36 cases across 32 studies were analyzed, focusing on patient demographics, symptomatology, diagnostic imaging, and histopathological features. The average patient age was 42.4 years. Common symptoms included dysuria, hematuria, and pelvic pain. Diagnostic challenges arise from the nonspecific nature of symptoms and imaging findings, making histopathological confirmation necessary. Surgical treatment is mainly involved, with transurethral resection being the most common approach. In some cases, hormonal therapy is also explored. While the prognosis is generally favorable, recurrence is possible, emphasizing the need for long-term follow-up. The review underscores the importance of early diagnosis and individualized management strategies to improve patient outcomes.

The diagnostic complexities posed by lesions within the urinary bladder underscore the need for personalised management approaches. Endocervicosis, a rare condition stemming from Müllerian tissue, is characterised by the benign infiltration of endocervical glands, predominantly affecting the urinary bladder. Despite the absence of definitive symptoms, meticulous preoperative assessment is imperative to ensure precise diagnosis and optimal surgical intervention. While typically benign, recent cases have hinted at a potential association with adenocarcinoma, underscoring the necessity for meticulous management. The management of endocervicosis lacks consensus, with suggested surgical modalities including transurethral resection or partial cystectomy. In this case, a 47-year-old woman presented to our department with chronic pelvic pain following hysterectomy for adenomyosis. Imaging tests revealed a solid lesion situated at the dome of the urinary bladder. Consequently, a segmental cystectomy with circular tumour-only excision, with minimal free surgical margins, was undertaken to preserve bladder integrity. Histopathological analysis confirmed the diagnosis of endocervicosis. While the reported cases of urinary bladder endocervicosis remain limited, this instance contributes valuable insights into its understanding and management. It underscores the pivotal role of accurate diagnosis and tailored surgical intervention in optimising patient outcomes and mitigating postoperative complications, with tumour-only excision emerging as a promising and feasible approach. [ABSTRACT FROM AUTHOR]

Resumen: La endocervicosis vesical es una entidad rara con pocos casos publicados en la literatura, consiste en la presencia de glándulas de tejido endocervical en vejiga, generalmente en cúpula posterior1,2. Se suele dar en mujeres en edad reproductiva o con antecedentes de endometriosis o endosalpingosis por su probable origen en el sistema de Müller1–6. Se puede confundir radiológicamente con un tumor maligno, por tanto, es muy importante realizar un diagnóstico certero para evitar tratamientos radicales1,2,5,6. Abstract: Endocervicosis is an uncommon and unknown disease. It is a benign pathology. It is an alteration of the endocervical glands outside their location, specifically in the bladder.We present a case of bladder endocervicosis in a postmenopausal woman detected by clinical ultrasound at the health care centre. We discuss the etiology, differential diagnóstico and treatment of this pathology and the relevance of clinical ultrasound in primary care for early diagnóstico.This disease could simulate malignancy, being a diagnostic challenge for the anatomopathologist. It is important to know about this disease to avoid invasive treatments for the patient.

Benign müllerian inclusions are frequently encountered within infra-diaphragmatic locations such as pelvic lymph nodes, bladder, cervix and vagina. Supra-diaphragmatic müllerian inclusions, especially endocervicosis, are exceedingly rare. We report a case of endocervicosis within an intramammary lymph node in a 49-year-old woman. To the best of our knowledge, this is the second reported case. [ABSTRACT FROM AUTHOR]

Bladder endocervicosis describes the ectopic presence of endocervical tissue within the bladder. It is a rare condition with an unclear aetiology. We report the case of a 29-year-old woman who presented with bladder endocervicosis during her first pregnancy with recurrence during her second pregnancy. On both occasions, the patient was treated with transurethral resection and the lesion recurred. This is the first case in the literature of bladder endocervicosis presenting during pregnancy and suggests a hormonal stimulus is important in its development.

Mullerianosis is a term used to describe a pathologic entity comprised of at least 2 types of Mullerian-type epithelia (tubal, endocervical, or endometrial) at non-gynecologic sites. This is an uncommon occurrence in the urinary tract. To the best of our knowledge, only 3 instances of Mullerianosis involving the ureter have been reported. We present a fourth report and describe the clinical, radiological, and histopathologic findings. Awareness of this rare process is crucial to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Objectives: The disruption or defect of the myometrium in the uterine scar of a cesarean section (CS) has been known by various names, such as uterine niche, isthmocele, deficient uterine scar, scar pouch, or diverticulum. Symptomatology, risk factors for niche development, and available treatment modalities have been recently studied. However, the histologic features of this disease remain unknown.Methods: The histologic features of eight uterine niches are thoroughly described and a summary of the most important aspects of the uterine niche literature is provided. Five cases of CS scars without niche formation are comparatively examined.Results: Most uterine niches harbor endocervical mucosa, often cystically dilated and/or an atrophic or disorganized endometrial mucosa of lower uterine segment origin. Regenerative epithelial atypia and fibroblastic stromal reaction are frequent features. No granulomatous reaction, important inflammation, or hemorrhage is seen. CS scars without niche formation do not harbor endocervical mucosa or inclusion cysts, fibroblastic stroma, or regenerative atypia.Conclusions: As more prospective studies of uterine niche development and treatment will be conducted, a detailed pathologic report with the criteria proposed herein can be designed. [ABSTRACT FROM AUTHOR]

Bladder endocervicosis describes the ectopic presence of endocervical tissue within the bladder. It is a rare condition with an unclear aetiology. We report the case of a 29-year-old woman who presented with bladder endocervicosis during her first pregnancy with recurrence during her second pregnancy. On both occasions, the patient was treated with transurethral resection and the lesion recurred. This is the first case in the literature of bladder endocervicosis presenting during pregnancy and suggests a hormonal stimulus is important in its development. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: We reviewed reported cases of endocervicosis, endosalpingiosis, and müllerianosis of the bladder or ureters in women in order to highlight these conditions as distinct from endometriosis or adenomyosis. Methods: Medline and Scopus searches of all cases published till the October 1, 2017. All retrieved references were searched manually to identify relevant articles. Results: Twenty-six articles reported endocervicosis. These included 37 cases described by the authors as endocervicosis of the bladder. We identified 7 case reports of bladder endosalpingiosis. There were 26 publications including 27 cases of müllerianosis of the bladder and 3 cases affecting the lower ureter. Literature descriptions are limited but available accounts do not point to features that uniquely distinguished these conditions. Affected women tended to be older, and in many cases, there was a possible relation to past surgery and particularly to hysterectomy and caesarean sections. Many cases were reported in postmenopausal women. Local excision was sufficient in most cases. Conclusion: The etiology of these conditions remains speculative, but case reports raise a possible link to pelvic surgery. There is a need for more detailed accounts of these lesions, which should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain or discomfort, dysuria, frequency, or hematuria. [ABSTRACT FROM AUTHOR]

Bladder endocervicosis is a benign disease, characterized by the presence of ectopic endocervical tissue in the bladder wall, with few cases described in the literature. A case of bladder endocervicosis in a 35-year-old female, with the previous history of cesarean section, subtotal hysterectomy, and right oophorectomy is reported here. The patient was asymptomatic and the bladder lesion was detected on pelvic ultrasonography. Transurethral bladder resection was performed and the histopathological analysis revealed bladder endocervicosis. 12 months of follow-up have passed without evidence of clinical or radiological recurrence. Clinical presentation, pathological features, and treatment are discussed.

Selskyy P. R. Изменения клеточного звена местного иммунитета шейки матки у больных с цервикальной интраэпителиальной неоплазией на фоне эндоцервикоза = Changes in cellular local immunity of the cervix in patients with cervical intraepithelial neoplasia on the basis of endocervicosis. Journal of Education, Health and Sport. 2015;5(9):685-693. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.32168 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%289%29%3A685-693 https://pbn.nauka.gov.pl/works/657207 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2015. Revised 05.09.2015. Accepted: 29.09.2015. Изменения клеточного звена местного иммунитета шейки матки у больных с цервикальной интраэпителиальной неоплазией на фоне эндоцервикоза Changes in cellular local immunity of the cervix in patients with cervical intraepithelial neoplasia on the basis of endocervicosis П. Р. Сельський P. R. Selskyy Государственное высшее учебное заведение “Тернопольский государственный медицинский университет имени И.Я. Горбачевского МОЗ Украины”, Тернополь, Украина State higher education establishment “Ternopil State Medical University by I. Ya. Horbachevsky of Ministry of Public Health of Ukraine” Summary Histological and immunomorphological investigation of 91 patients on endocervicosis and 11 patients on CIN is are carried out. The analysis of cellular circuid of immunity was taken with the help of monoclone antibodies to antigens lymphocytes CD3, CD4, CD8 and CD19. Majority of the patients with endocervicosis the infringement T-cellular of circuid immunity was observed. The density of the cellular infiltrate, including CD3-lymphocytes in the stroma of the cervix by endocervicosis with CIN did not differ from similar indicators by endocervicosis with no signs of dysplasia. The change in the proliferative activity of the epithelium in the area of dysplasia was revealed. On the basis of investigations we can make the conclusion about essential influence of the violation of the regeneration in conjunction with the immunity factors on endocervicosis progress. Keywords: endocervicosis, cervical intraepithelial neoplasia, cellular immunity, cellular infiltration Резюме Проведено гистологическое, морфометрическое и иммуноморфологическое исследование 91 больной с эндоцервикозом и 11 больных с цервикальной интраэпителиальной неоплазией (CIN). Анализ клеточного звена иммунитета проводился с помощью моноклональных антител к антигенам лимфоцитов CD3, CD4, CD8 и CD19. У большинства пациенток с эндоцервикозом наблюдалось нарушение Т-клеточного звена иммунитета. Плотность клеточного инфильтрата, в том числе CD3-лимфоцитов, в строме шейки матки при эндоцервикозе, совмещенном с СIN, не отличалась от аналогичных показателей при эндоцервикозе без признаков дисплазии. Выявлено существенное изменение пролиферативной активности эпителия в области дисплазии. На основе проведенных исследований можно сделать вывод о существенном влиянии нарушения регенерации в сочетании с местными иммунными факторами на прогрессирование данного заболевания. Ключевые слова: эндоцервикоз, цервикальная интраэпителиальная неоплазия, клеточный иммунитет, клеточный инфильтрат.

Selskyy P. R. Изменения клеточного звена местного иммунитета шейки матки у больных с различными видами эндоцервикоза = Changes in cellular local immunity of the cervix in patients with different types of endocervicosis. Journal of Education, Health and Sport. 2015;5(8):448-456. ISSN 2391-8306. DOI10.5281/zenodo.31459 http://dx.doi.org/10.5281/zenodo.31459 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%288%29%3A448-456 https://pbn.nauka.gov.pl/works/634507 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 26.07.2015. Revised 05.08.2015. Accepted: 24.08.2015. Изменения клеточного звена местного иммунитета шейки матки у больных с различными видами эндоцервикоза Changes in cellular local immunity of the cervix in patients with different types of endocervicosis П. Р. Сельський P. R. Selskyy Государственное высшее учебное заведение “Тернопольский государственный медицинский университет имени И.Я. Горбачевского МОЗ Украины”, Тернополь, Украина State higher education establishment “Ternopil State Medical University by I. Ya. Horbachevsky of Ministry of Public Health of Ukraine” Summary Histological and immunomorphological investigation of 91 patients on endocervicosis is are carried out. The analysis of cellular circuid of immunity was taken with the help of monoclone antibodies to antigens lymphocytes CD3, CD4, CD8 and CD19. Majority of the patients with endocervicosis the infringement T-cellular of circuid immunity was observed. The dependence of immune changes from a degree of development of endocervicosis is revealed. On the basis of investigations we can make the conclusion about essential influence of the immunity factors in conjunction with the violation of the regeneration on endocervicosis progress. Keywords: endocervicosis, cellular immunity, cellular infiltration. Резюме Проведено гистологическое, морфометрическое и иммуноморфологическое исследование 91 больной с эндоцервикозом. Анализ клеточного звена иммунитета проводился с помощью моноклональных антител к антигенам лимфоцитов CD3, CD4, CD8 и CD19. У большинства пациенток с эндоцервикозом наблюдалось нарушение Т-клеточного звена иммунитета. Обнаружена зависимость иммунных нарушений от степени развития эндоцервикоза. На основе проведенных исследований можно сделать вывод о существенном влиянии местных иммунных факторов в сочетании с нарушением регенерации на прогрессирование данного заболевания. Ключевые слова: эндоцервикоз, клеточный иммунитет, клеточный инфильтрат.

Endocervicosis is a rare benign condition characterized by the presence of endocervical-type mucinous glands. Urinary bladder endocervicosis forms an elevated lesion in the posterior wall of the urinary bladder and is sometimes misdiagnosed as a malignant tumor clinically and pathologically. Herein we describe the first case of adenocarcinoma arising in urinary bladder endocervicosis. The patient, a 58-year-old woman, presented with asymptomatic hematuria. Cystoscopy revealed a nodular mass measuring 4 cm in diameter in the posterior wall, and total cystectomy was performed. Histology revealed that the elevated lesion of the bladder wall was composed of haphazard proliferation of cystic glands lined by benign endocervical-type epithelium. An adenocarcinoma arose at the center of this endocervicosis. Mucin histochemistry revealed the presence of sulfomucin in both the endocervicosis and adenocarcinoma components. Immunohistochemically, the endocervicosis was positive for cytokeratin ( CK) 7, AE1/ AE3, CAM5.2, HBME1, CA19-9, and estrogen receptor ( ER), and negative for CK20, CDX2, progesterone receptor ( PR), MUC5 AC, and β-catenin. The adenocarcinoma showed similar immunohistochemical results, except for loss of ER expression and a slight increase in the ratio of Ki-67-positive cells. This case indicates that endocervicosis, known as a benign lesion, harbors the possibility of malignant transformation. [ABSTRACT FROM AUTHOR]

Bladder endocervicosis is a benign disease, characterized by the presence of ectopic endocervical tissue in the bladder wall, with few cases described in the literature. A case of bladder endocervicosis in a 35-year-old female, with the previous history of cesarean section, subtotal hysterectomy, and right oophorectomy is reported here. The patient was asymptomatic and the bladder lesion was detected on pelvic ultrasonography. Transurethral bladder resection was performed and the histopathological analysis revealed bladder endocervicosis. 12 months of follow-up have passed without evidence of clinical or radiological recurrence. Clinical presentation, pathological features, and treatment are discussed. [ABSTRACT FROM AUTHOR]

The theory of müllerianosis predicts that embryonic müllerian tissue, misplaced during organogenesis, results in the formation of 4 benign müllerian diseases—developmental adenomyosis, endometriosis, endosalpingiosis, and endocervicosis—(developmental müllerian diseases) that will be identified in human female fetuses, infants, children, adolescents, and adults. Direct evidence is presented to support the existence of developmental adenomyosis, developmental endometriosis, and developmental endocervicosis in human female fetuses along with strong circumstantial evidence supporting the existence of all 4 developmental müllerian diseases in human female infants, children, adolescents, and adults. This evidence throws light upon the pathogenesis of rare müllerian lesions whose pathogenesis remains inexplicable by classical and modern theories. Furthermore, this research has scientific and clinical relevance: scientific relevance because it opens up a new field of comparative research—the 4 developmental müllerian diseases complement the 4 acquired müllerian diseases; clinical relevance because it identifies rare müllerian diseases curable by complete surgical excision. [ABSTRACT FROM AUTHOR]

Summary: Although extraovarian mucinous cystadenocarcinomas resemble primary ovarian carcinomas, both histologically and clinically, their specific etiology is not clear. This is the first report to show neoplastic transformation of endocervicosis into an extraovarian mucinous cystadenocarcinoma. The histologic spectrum and specific KRAS mutational analysis for this tumor were the same as for their ovarian counterparts. This supports a müllerian origin and the current approach to extrapolate the results from ovarian mucinous cystadenocarcinoma trials in prescribing treatment for patients with extraovarian mucinous cystadenocarcinomas. [Copyright &y& Elsevier]

Endocervicosis of the urinary bladder is a very rare tumor-like benign lesion. In the present report, a case in a 34-year-old woman, who has a prior Caesarean section at the age of 30 and 2-years history of dysuria, is described. Transvaginal ultrasound, cystoscopy and magnetic resonance imaging demonstrated a solid mass in the posterior wall of the bladder. The mass was removed and histology revealed a haphazard proliferation of endocervical-type mucinous glands scattered through the muscularis propria of bladder wall. Immunohistochemical phenotype of these glands was compared with three normal uterine endocervices and two cases of well-differentiated mucinous adenocarcinoma of the uterine cervix. Endocervicosis glands displayed positive reaction for antibodies against estrogen receptor, progesterone receptor, CAM 5.2, cytokeratin 7, CA125, HBME-1 and carcinoembryonic antigen, which showed positivity in normal endocervices. On the other hand, only glands of well-differentiated mucinous adenocarcinoma expressed human gastric mucin and showed high proliferative index of Ki-67. These results supported the hypothesis of its Müllerian origin. Furthermore, diffuse distribution of estrogen and progesterone receptors, lack of human gastric mucin and low proliferative activity were distinct features for endocervicosis compared to well-differentiated mucinous adenocarcinoma. [ABSTRACT FROM AUTHOR]

Abstract: Arias-Stella reaction is a hormone-induced atypical endometrial change that may involve endometrial, extraendometrial, or endometriotic sites. Establishing a correct diagnosis of Arias-Stella reaction may sometimes be problematic when seen outside of the uterine corpus, particularly in a limited biopsy sample when the pathologist is not aware of the clinical history. We report an Arias-Stella reaction in bladder endometriosis, which presented as a bladder mass in a 25-year-old pregnant woman. Clinical information of intrauterine pregnancy (week 16) was not initially provided when the biopsy was performed. We also discuss endometriosis, endocervicosis, and müllerianosis of the bladder, which are benign glandular lesions that may mimic tumors within the bladder wall. [Copyright &y& Elsevier]

Endocervicosis of the urinary bladder is a rare benign condition exclusively seen in women, usually of reproductive age. To the best of our knowledge there are only about twenty cases reported so far. It causes non-specific symptoms and is seen as a submucosal lesion on cystoscopy. On histological examination one finds endocervical glands embedded deep within the muscle layers. It can be confused with an adenocarcinoma of the bladder. Unless the correct diagnosis is made these patients can undergo potentially debilitating surgery. As demonstrated in our patient even symptomatic endocervicosis can be managed conservatively. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Two cases of a diffuse histiocytic proliferation that mimicked mesothelial hyperplasia in the pelvic peritoneum of premenopausal women with endocervicosis arc presented. The lesions were found incidentally on laparoscopic examination for pelvic pain and appeared as small friable excrescenses attached to the serosal surface of the pelvis. Histologic examination revealed a dense proliferation of round to oval cells with abundant eosinophilic cytoplasm and large, hyperchromatic nuclei showing focal invaginations and occasional mitoses. The cells appeared to infiltrate the surrounding connective tissue in single files and were closely associated with sloughed strands of small, cuboidal mesothelial cells as well as with larger glands lined by mucinous epithelium. Immunohistochemical studies showed cytoplasmic staining of these cells with MAC587, HAM56, and alpha-1-antichymotrypsin antibodies, thus supporting their histiocytic nature. The close association of the histiotytic proliferation with the endocervicotic glands raises the possibility that the process may have resulted as a reaction to rupture and extrusion of the mucous contents of the glands into the surrounding stroma. These lesions must be distinguished from reactive or neoplastic mesothelial proliferations involving the female pelvic peritoneum. [ABSTRACT FROM AUTHOR]

Endocervicosis of the bladder is a rare, benign variant of endometriosis. The lesions are characterized by ectopic, glandular structures of Müllerian origin with intracytoplasmic mucin production. During placement of a ureteral stent, a cystic tumor in the posterior bladder wall was discovered in a 47-year-old woman with nephroureterolithiasis. CT and MRI revealed a 5×1.6 cm2 mass in the posterior bladder wall protruding into the lumen of the bladder. Urine culture and cytological analyses showed no malignancy. Transurethral biopsy of the tumor confirmed the diagnosis of endocervicosis. Complete transurethral resection was rejected due to the absence of symptoms and the benign condition of the lesion. [ABSTRACT FROM AUTHOR]